Affes Zied, Rekik Salaheddine, Ben Saad Helmi
Department of Physiology and Functional Exploration, Farhat HACHED University Hospital of Sousse, Sousse, Tunisia.
Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.
Libyan J Med. 2015 Oct 8;10(1):28946. doi: 10.3402/ljm.v10.28946. eCollection 2015.
There is no clear consensus as to what constitutes an obstructive ventilatory defect (OVD): Is it FEV1/FVC<lower limit of normal (LLN) or<0.70 (respectively, physiological and operational definitions)?
To determine, according to the two definitions, the percentage of subjects having an OVD among them explored in a lung function exploration laboratory.
This is a retrospective study including 4,730 subjects aged 17-85 years. Subjects were divided according to the presence [physio (+) or operat (+)] or absence [physio (-) or operat (-)] of an OVD, and into younger (<45 years, n=2,076), older (≥45 years, n=2,654), smokers (n=1,208), and non-smokers (n=3,522) groups.
For the total sample, the younger and older groups [mean±SD of age (years), respectively, 46.7±14.1; 33.9±7.4, and 56.8±9.1], the 'physiological definition' detected, respectively, 13.46, 43.22, and 5.09% more OVD than the 'operational one' (p<0.05). In addition, the operational definition, compared with the physiological one, overdiagnosed OVD in 2.33 and 0.44% of smokers and non-smokers, respectively, and underdiagnosed it in 4.46% and 29.72% of smokers and non-smokers, respectively (p<0.05). Compared with the group 'physio (-), operat (+)', the 'physio (+), operat (-)' one was younger (74.2±4.7 years vs. 40.9±10.3 years) and had significantly higher FEV1 (62±13% vs. 78±17%) and FVC (71±15% vs. 93±19%).
The frequency of OVD much depends on the criteria used for its definition.
对于什么构成阻塞性通气功能障碍(OVD)尚无明确共识:是第一秒用力呼气容积/用力肺活量(FEV1/FVC)<正常下限(LLN)还是<0.70(分别为生理学定义和操作定义)?
根据这两种定义,确定在肺功能检测实验室接受检测的受试者中患有OVD的受试者百分比。
这是一项回顾性研究,纳入了4730名年龄在17 - 85岁之间的受试者。根据是否存在OVD[生理学定义阳性(physio(+))或操作定义阳性(operat(+))]或不存在[生理学定义阴性(physio(-))或操作定义阴性(operat(-))],将受试者分为年轻组(<45岁,n = 2076)、年长组(≥45岁,n = 2654)、吸烟组(n = 1208)和非吸烟组(n = 3522)。
对于总样本,年轻组和年长组[年龄(岁)的均值±标准差分别为46.7±14.1;33.9±7.4以及56.8±9.1],“生理学定义”检测出的OVD比“操作定义”分别多13.46%、43.22%和5.09%(p<0.05)。此外,与生理学定义相比,操作定义在吸烟组和非吸烟组中分别将2.33%和0.44%的OVD过度诊断,而在吸烟组和非吸烟组中分别将4.46%和29.72%的OVD漏诊(p<0.05)。与“生理学定义阴性,操作定义阳性”组相比,“生理学定义阳性,操作定义阴性”组年龄更小(74.2±4.7岁对40.9±10.3岁),且FEV1(62±13%对78±17%)和FVC(71±15%对93±19%)显著更高。
OVD的发生率很大程度上取决于其定义所采用的标准。