Ruppel Gregg L, Carlin Brian W, Hart Mary, Doherty Dennis E
Pulmonary Function Testing Laboratory, St Louis University Hospital, St Louis, Missouri.
Sleep Medicine and Lung Health Consultants, Pittsburgh, Pennsylvania.
Respir Care. 2018 Feb;63(2):242-252. doi: 10.4187/respcare.05710.
The use of office spirometry was recommended by the National Lung Health Education Program (NLHEP) consensus conference in 1999 for detection and management of COPD. Since that time, spirometry utilization has increased, but its role in the diagnosis of COPD is still evolving. This update reviews the role of spirometry for screening and case finding in COPD as well as for asthma. Spirometry has been used for disease management in patients with airway obstruction, with varying results. The diagnostic criteria for COPD using spirometry have also evolved in the past 17 years, with differences arising between the Global Initiative for Chronic Obstructive Lung Disease and NLHEP recommendations. More sophisticated spirometers as well as new reference equations are widely available. Standardization guidelines from the American Thoracic Society/European Respiratory Society published in 2005 provide a robust framework for performing and interpreting spirometry, but clinicians still need hands-on training and meaningful feedback to perform high-quality spirometry in the office setting.
1999年，国家肺部健康教育计划（NLHEP）共识会议推荐使用办公室肺量计来检测和管理慢性阻塞性肺疾病（COPD）。自那时起，肺量计的使用有所增加，但其在COPD诊断中的作用仍在不断发展。本更新回顾了肺量计在COPD以及哮喘筛查和病例发现中的作用。肺量计已用于气道阻塞患者的疾病管理，结果各异。在过去17年中，使用肺量计诊断COPD的标准也在不断演变，全球慢性阻塞性肺疾病倡议和NLHEP的建议之间出现了差异。更先进的肺量计以及新的参考方程已广泛可用。2005年美国胸科学会/欧洲呼吸学会发布的标准化指南为进行和解读肺量计提供了一个强大的框架，但临床医生仍需要实践培训和有意义的反馈，以便在办公室环境中进行高质量的肺量计检查。
