Czajkowska-Malinowska Małgorzata, Tomalak Waldemar, Radliński Jakub
Department of Lung Diseases and Respiratory Failure, Kujawy-Pomorze Regional Centre of Pulmonology in Bydgoszcz.
Pneumonol Alergol Pol. 2013;81(6):511-7.
Spirometry is the basic method used to diagnose and monitor obstructive diseases. Spirometric tests are performed in more and more people of advanced age (more than 65 years old). The objective of the study was to assess the quality of spirometry (measurement of the flow-volume curve) in subjects of the aforementioned age group, with reference to applicable quality criteria specified in guidelines ERS/ATS 2005 and PTChP 2006.
The study was of a retrospective nature. The authors analysed the results of spirometry performed in 1271 subjects who were 65 to 94 years old and who underwent spirometric tests in the Respiratory Physiopathology Laboratory of Kujawy-Pomorze Regional Centre of Pulmonology in Bydgoszcz over a period of 6 months. This group included 759 males (average age 73.2 ± 5.9 years) and 512 females (average age 73.2 ± 5.7 years). The quality of the spirometry was assessed according to error codes assigned to individual spirometric sessions by the software JLab 5.31 installed in the measuring system MasterScreen (CareFusion).
Twenty-nine (2.3%) of the 1271 subjects failed to perform spirometric measurements. For the remaining 1242 subjects the following spirometry quality was determined: correctly performed spirometric test in 415 (33.4%) subjects; one error in 673 (54.2%) subjects; 2 errors in 136 (11%) subjects; 3 errors in 15 (1.2%) subjects and 4 errors in 3 (0.2%) subjects. The analysis of individual errors revealed that the lack of a plateau at the end of exhalation was found in 747 (60.1%) subjects (including only 25 (2%) subjects with FET < 6 s); increased BEV value in 7 (0.6%) subjects; abruptly finished exhalation in 36 (2.9%) subjects; and no FVC and FEV₁ repeatability in 43 (3.5%) and 169 (13.6%) subjects, respectively.
The most common error was the lack of a plateau at the end of exhalation. Therefore, paying particular attention to the final phase of exhalation during spirometry should, as a result, increase the percentage of correctly performed spirometric tests in the elderly.
肺活量测定法是用于诊断和监测阻塞性疾病的基本方法。越来越多的老年人（65岁以上）接受肺活量测定测试。本研究的目的是参照ERS/ATS 2005指南和PTChP 2006中规定的适用质量标准，评估上述年龄组受试者的肺活量测定质量（流量-容积曲线测量）。
本研究为回顾性研究。作者分析了1271名年龄在65至94岁之间的受试者的肺活量测定结果，这些受试者在6个月内于比得哥什的库亚维-波美拉尼亚地区肺病中心呼吸生理病理学实验室接受了肺活量测定测试。该组包括759名男性（平均年龄73.2±5.9岁）和512名女性（平均年龄73.2±5.7岁）。根据安装在MasterScreen（CareFusion）测量系统中的JLab 5.31软件分配给各个肺活量测定环节的错误代码，评估肺活量测定的质量。
1271名受试者中有29名（2.3%）未能完成肺活量测定。对于其余1242名受试者，确定了以下肺活量测定质量：415名（33.4%）受试者的肺活量测定测试执行正确；673名（54.2%）受试者有一个错误；136名（11%）受试者有两个错误；15名（1.2%）受试者有三个错误；3名（0.2%）受试者有四个错误。对个别错误的分析显示，747名（60.1%）受试者呼气末无平台期（其中只有25名（2%）受试者用力呼气时间<6秒）；7名（0.6%）受试者的呼气末容积增加值升高；36名（2.9%）受试者呼气突然结束；43名（3.5%）和169名（13.6%）受试者分别无用力肺活量（FVC）和第一秒用力呼气容积（FEV₁）的重复性。
最常见的错误是呼气末无平台期。因此，在肺活量测定过程中特别注意呼气的最后阶段，应能提高老年人中肺活量测定测试执行正确的百分比。
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