Pattishall E N
Children's Hospital of Pittsburgh, University of Pittsburgh, PA.
Pediatrics. 1990 May;85(5):768-73.
A questionnaire was sent to all pediatric training programs to evaluate the use of pulmonary function reference standards and the interpretation of pulmonary function test results. Responses were obtained from 107 of 130 institutions, and 94 of these had pulmonary function laboratories available. Of the 94, 60 used one of three reference standards. The primary reason the reference standards were chosen was either unknown or because they came with the spirometer (24), were recommended by another person or were those used in that person's training (34), or were thought to be the best standards available or most applicable to the population to be tested (31). To define abnormality, most used an 80% predicted cutoff for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow at 25% to 75% vital capacity. For a change in an individual through time, most used a 10% change for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow at 25% to 75% vital capacity. Thirteen used statistical methods to define abnormal individuals and none used statistical methods to define a significant change over time. Although there are a few guidelines for reference standards and interpretations of pulmonary function tests, it appears that most laboratories are not using those guidelines and that further guidelines and education are needed.
向所有儿科培训项目发放了一份调查问卷，以评估肺功能参考标准的使用情况以及肺功能测试结果的解读情况。130家机构中有107家回复了问卷，其中94家设有肺功能实验室。在这94家机构中，60家使用了三种参考标准中的一种。选择参考标准的主要原因要么未知，要么是因为它们随肺活量计附带（24家），由他人推荐或为该人培训时所使用的标准（34家），要么被认为是现有的最佳标准或最适用于受试人群的标准（31家）。为定义异常情况，大多数机构将用力肺活量、第1秒用力呼气容积以及25%至75%肺活量时的用力呼气流量的预测值下限设定为80%。对于个体随时间的变化，大多数机构将用力肺活量、第1秒用力呼气容积以及25%至75%肺活量时的用力呼气流量的变化幅度设定为10%。13家机构使用统计方法来定义异常个体，没有机构使用统计方法来定义随时间的显著变化。尽管对于肺功能测试的参考标准和解读有一些指导原则，但似乎大多数实验室并未遵循这些指导原则，因此需要进一步的指导原则和培训。
