Department of Epidemiology, on Tobacco and Chronic Obstructive Pulmonary Disease, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.
Department of Investigation on Tobacco and Chronic Obstructive Pulmonary Disease, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.
Rev Invest Clin. 2020 Dec 22;72(6):386-393. doi: 10.24875/RIC.20000235.
A 6 s spirometry with an inexpensive pocket spirometer efficiently selects individuals for a diagnostic-quality spirometry for airflow limitation, but could also be useful to identify individuals with a restrictive pattern.
We evaluated an inexpensive simplified spirometer (chronic obstructive pulmonary disease [COPD]-6) as a screening tool to identify spirometric abnormalities.
A population-based survey in Mexico City, with 742 participants performing pre- and post-BD spirometry and a three-maneuver 6 s spirometry (pre-BD) with a COPD-6. We evaluated forced expiratory volume in 1 s (FEV1), FEV6, and FEV1/FEV6 from the COPD-6, crude and expressed as the percentage of predicted (%P), to discriminate post-bronchodilator airflow obstruction (FEV1/forced vital capacity [FVC] < 5th percentile) or restriction (FVC or FEV1 <5th percentile with normal FEV1/FVC) through receiver operating characteristics and their area under the curve (AUC).
FEV1%P was the best predictor to identify pre- and post-BD ventilatory abnormalities (best cutoff point 87%P, AUC 92% for restrictive pattern, 89% for obstructive pattern, and 91% for any spirometric abnormality). Deriving to clinical spirometry only those with < 87%P (26% of the sample) missed only 12% of spirometric abnormalities most of the latter mild.
An FEV1 < 87%P from a pre-BD 6 s spirometry correctly identified individuals with spirometric ventilatory defects, either obstructive or restrictive.
使用廉价的口袋式肺量计进行 6 秒肺活量测定，可以有效地筛选出需要进行诊断质量的气流受限性肺功能检查的个体，但也可用于识别存在限制性模式的个体。
我们评估了一种廉价的简化肺量计（COPD-6）作为筛选工具，以识别肺功能异常。
在墨西哥城进行了一项基于人群的调查，共有 742 名参与者进行了支气管扩张剂前和后肺功能检查，以及使用 COPD-6 进行的三步骤 6 秒肺活量测定（支气管扩张剂前）。我们评估了 COPD-6 的 1 秒用力呼气量（FEV1）、FEV6 和 FEV1/FEV6，原始值和以预计值的百分比（%P）表示，以通过接收者操作特征及其曲线下面积（AUC）来区分支气管扩张剂后气流阻塞（FEV1/用力肺活量[FVC] <第 5 百分位数）或限制（FVC 或 FEV1 <第 5 百分位数，且 FEV1/FVC 正常）。
FEV1%P 是预测预和后支气管扩张剂通气异常的最佳指标（最佳截断点为 87%P，限制性模式的 AUC 为 92%，阻塞性模式为 89%，任何肺功能异常为 91%）。从临床肺功能检查中仅排除<87%P 的患者（占样本的 26%），仅漏诊了约 12%的肺功能异常，而且后者大多数为轻度异常。
支气管扩张剂前 6 秒肺活量测定中 FEV1 < 87%P 可正确识别出存在阻塞性或限制性通气缺陷的个体。
