Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany. stefan.karrasch @ med.uni-muenchen.de
Respiration. 2013;85(3):210-9. doi: 10.1159/000338780. Epub 2012 Jul 10.
The diagnostic use of lung function using spirometry depends on the validity of reference equations. A multitude of spirometric prediction values have been published, but in most of these studies older age groups are underrepresented.
The aim of the present study was to establish new spirometric reference values for advanced age and to compare these to recent prediction equations from population-based studies.
In the present study spirometry was performed in a population-based sample from the KORA-F4 and KORA-Age cohorts (2006-2009, Augsburg, Germany) comprising 592 never-smoking subjects aged 42-89 years and with no history of respiratory disease. Using quantile regression analysis, equations for the median and lower limit of normal were derived for indices characterizing the expiratory flow-volume curve: forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, peak expiratory flow (PEF), and forced expiratory flow rates at 25, 50 and 75% of exhaled FVC (FEF25, FEF50 and FEF75).
FEV1 and FVC were slightly higher, and PEF was lower compared to recently published equations. Importantly, forced expiratory flow rates at middle and low lung volume, as putative indicators of small airway disease, were in good agreement with recent data, especially for older age.
Our study provides up-to-date reference equations for all major indices of flow-volume curves in middle and advanced age in a South German population. The small deviations from published equations indicate that there might be some regional differences of lung function within the Caucasian population of advanced age in Europe.
肺功能的诊断使用依赖于呼吸量测定法的有效性。大量的呼吸量预测值已经公布，但在这些研究中，年龄较大的群体代表性不足。
本研究旨在为高龄人群建立新的呼吸量测定法参考值，并将这些值与最近基于人群的研究中的预测方程进行比较。
在本研究中，对来自 KORA-F4 和 KORA-Age 队列（2006-2009 年，德国奥格斯堡）的一个基于人群的样本进行了呼吸量测定法检查，该样本由 592 名从不吸烟、年龄在 42-89 岁且无呼吸系统疾病史的受试者组成。使用分位数回归分析，为描述呼气流量-容积曲线特征的指数（FEV1、FVC、FEV1/FVC、PEF 以及呼气肺活量的 25%、50%和 75%时的强制呼气流量率 FEF25、FEF50 和 FEF75）推导出中位数和正常下限的方程。
与最近公布的方程相比，FEV1 和 FVC 略高，PEF 略低。重要的是，中低肺容量时的强制呼气流量率作为小气道疾病的潜在指标，与最近的数据非常吻合，尤其是在高龄人群中。
我们的研究为德国南部人群中年和高龄时的主要流量-容积曲线指数提供了最新的参考方程。与公布的方程相比，小的偏差表明在欧洲高龄白种人群中肺功能可能存在一些区域性差异。
