Jarenbäck Linnea, Ankerst Jaro, Bjermer Leif, Tufvesson Ellen
Department of Clinical Sciences, Respiratory Medicine and Allergology, Lund University, 221 84 Lund, Sweden.
Pulm Med. 2013;2013:782052. doi: 10.1155/2013/782052. Epub 2013 Jun 13.
Classification of COPD into different GOLD stages is based on forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) but has shown to be of limited value. The aim of the study was to relate spirometry values to more advanced measures of lung function in COPD patients compared to healthy smokers. The lung function of 65 COPD patients and 34 healthy smokers was investigated using flow-volume spirometry, body plethysmography, single breath helium dilution with CO-diffusion, and impulse oscillometry. All lung function parameters, measured by body plethysmography, CO-diffusion, and impulse oscillometry, were increasingly affected through increasing GOLD stage but did not correlate with FEV1 within any GOLD stage. In contrast, they correlated fairly well with FVC%p, FEV1/FVC, and inspiratory capacity. Residual volume (RV) measured by body plethysmography increased through GOLD stages, while RV measured by helium dilution decreased. The difference between these RV provided valuable additional information and correlated with most other lung function parameters measured by body plethysmography and CO-diffusion. Airway resistance measured by body plethysmography and impulse oscillometry correlated within COPD stages. Different lung function parameters are of importance in COPD, and a thorough patient characterization is important to understand the disease.
慢性阻塞性肺疾病（COPD）分为不同的全球慢性阻塞性肺疾病倡议（GOLD）阶段是基于1秒用力呼气容积（FEV1）和用力肺活量（FVC），但已显示其价值有限。本研究的目的是将肺量计值与COPD患者相比健康吸烟者更先进的肺功能测量指标相关联。使用流速-容量肺量计、体容积描记法、单次呼吸氦稀释法结合一氧化碳弥散和脉冲振荡法对65例COPD患者和34例健康吸烟者的肺功能进行了研究。通过体容积描记法、一氧化碳弥散和脉冲振荡法测量的所有肺功能参数随着GOLD阶段的增加而受到越来越大的影响，但在任何GOLD阶段内均与FEV1无相关性。相比之下，它们与FVC%p、FEV1/FVC和吸气容量相关性相当好。通过体容积描记法测量的残气量（RV）随GOLD阶段增加，而通过氦稀释法测量的RV降低。这两种RV测量值之间的差异提供了有价值的额外信息，并与通过体容积描记法和一氧化碳弥散测量的大多数其他肺功能参数相关。通过体容积描记法和脉冲振荡法测量的气道阻力在COPD各阶段内具有相关性。不同的肺功能参数在COPD中具有重要意义，全面的患者特征描述对于理解该疾病很重要。
