[肺量计的新国际参考值：通过对儿科人群的比较分析探讨对临床问题的影响]
[New international reference values for spirometry: implications for clinical issues using a comparative analysis of a paediatric population].
作者信息
Lex Christiane, Korten Insa, Hofmann Alexander, Renner Sabine, Szepfalusi Zsolt, Frischer Thomas, Zacharasiewicz Angela
机构信息
Klinik für Pädiatrische Kardiologie und Intensivmedizin, Schwerpunkt Kinderpneumologie/-allergologie, Universitätsmedizin, Robert-Koch-Strasse 40, Göttingen, Deutschland.
Universitätsklinik und Poliklinik für Kinderheilkunde und Jugendmedizin, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland.
出版信息
Wien Med Wochenschr. 2015 Sep;165(17-18):361-5. doi: 10.1007/s10354-015-0387-0. Epub 2015 Sep 16.
BACKGROUND
The new lung function reference values of the global lung initiative (GLI) are recommended by most health societies. The aim of this study was to analyze FEV1- and FEV1/FVC-values from a German and Austrian patient group applying old and new reference values.
RESULTS
A total of 215 Caucasian children (aged 5-17 years) were included. FEV1-values were significantly lower applying GLI reference values compared to Zapletal values (median 96.9 % pred. (87.3-105.2) versus 100.6 % pred. (quartile 91.5-111.4), p = 0.000), the median difference was 4.9 % (range -12.9 to 27.5) % pred. Differences correlated significantly with age and FEV1 in % predicted (Zapletal), p = 0.000 17/70 (24 %) patients with cystic fibrosis had FEV1-values <80% pred. applying Zapletal, in 25 (36 %) patients FEV1 was abnormal (z-score <1645) using GLI values; 3/145 asthmatics (2 %) had FEV1-Werte <80 % d.S. (Zapletal), 7/145 (5 %) z-scores <1645 (GLI).
CONCLUSION
Differences between GLI-and Zapletal-reference values were considerable in pediatric asthma and CF-patients.
背景
全球肺倡议（GLI）的新肺功能参考值被大多数健康协会推荐。本研究的目的是分析应用新旧参考值的德国和奥地利患者组的第一秒用力呼气容积（FEV1）和FEV1/用力肺活量（FVC）值。
结果
共纳入215名白种儿童（5 - 17岁）。与扎普莱塔尔值相比，应用GLI参考值时FEV1值显著更低（中位数为预测值的96.9%（87.3 - 105.2），而扎普莱塔尔值为预测值的100.6%（四分位数91.5 - 111.4），p = 0.000），中位数差异为4.9%（范围 - 12.9至27.5）%预测值。差异与年龄和预测值百分比形式的FEV1显著相关（扎普莱塔尔值），p = 0.000。17/70（24%）的囊性纤维化患者应用扎普莱塔尔值时FEV1值<预测值的80%，25（36%）名患者应用GLI值时FEV1异常（z分数< - 1.645）；3/145（2%）的哮喘患者应用扎普莱塔尔值时FEV1值<预计值的80%，7/145（5%）的患者z分数< - 1.645（GLI值）。
结论
在儿童哮喘和囊性纤维化患者中，GLI和扎普莱塔尔参考值之间存在相当大的差异。
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