Matsuo Mitsuhiro
Department of Anesthesiology, Itoigawa General Hospital, Itoigawa, Japan.
JMA J. 2020 Jul 15;3(3):251-257. doi: 10.31662/jmaj.2019-0076. Epub 2020 Jun 19.
A widely used reference range for pulmonary function testing was derived from middle-aged, healthy, non-smoking adults in Japan. This study examined the effect of age-related diseases on pulmonary function tests for older Japanese adults.
All patients aged ≥65 years who underwent spirometry before general and orthopedic surgeries in Itoigawa General Hospital (Niigata, Japan) from January 2014 to June 2019 were identified, and their charts were reviewed.
This study included 1050 Japanese patients (median age: 75 years). The median spirometric values of vital capacity, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC in all patients were 2.66 L [interquartile range; 2.24, 3.25], 2.57 L [2.13, 3.13], 1.98 L [1.66, 2.37], and 77.5% [72.2, 81.9], respectively. Multiple regression analyses revealed that spirometric values were significantly affected by age, body height, sex, smoking status, social dependency, dyslipidemia, diabetes, history of heart failure, peripheral artery disease, end-stage renal disease, neuromuscular disease, and psychiatric disorders. Male sex and height were positively correlated with FVC and FEV1. Other factors, such as a history of heart failure, neuromuscular disease, and independent physical activity, were negatively correlated with FVC and FEV1 to almost the same extent as that of age.
These data will provide clinically useful information to accurately interpret pulmonary function test results in older Japanese adults.
广泛使用的肺功能测试参考范围源自日本中年健康非吸烟成年人。本研究调查了老年相关疾病对日本老年成年人肺功能测试的影响。
确定了2014年1月至2019年6月期间在糸鱼川综合医院（日本新潟）接受普通外科和骨科手术前进行肺活量测定的所有年龄≥65岁的患者，并查阅了他们的病历。
本研究纳入了1050名日本患者（中位年龄：75岁）。所有患者肺活量、用力肺活量（FVC）、第1秒用力呼气量（FEV1）和FEV1/FVC的中位肺活量测定值分别为2.66 L[四分位间距；2.24，3.25]、2.57 L[2.13，3.13]、1.98 L[1.66，2.37]和77.5%[72.2，81.9]。多元回归分析显示，肺活量测定值受年龄、身高、性别、吸烟状况、社会依赖程度、血脂异常、糖尿病、心力衰竭病史、外周动脉疾病、终末期肾病、神经肌肉疾病和精神障碍的显著影响。男性和身高与FVC和FEV1呈正相关。其他因素，如心力衰竭病史、神经肌肉疾病和独立体力活动，与FVC和FEV1呈负相关，其程度与年龄几乎相同。
这些数据将为准确解读日本老年成年人的肺功能测试结果提供临床有用信息。
