Wang Y M, Chen W Y, Jian W H, Gao Y, Zheng J P
National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2022 Mar 12;45(3):250-254. doi: 10.3760/cma.j.cn112147-20210412-00244.
Standardization of spirometry was jointly updated by the American Thoracic Society (ATS) and the European Respiratory Society (ERS) in 2019. Similar technical standards for spirometry recommended by the Chinese Thoracic Society (CTS) and/or the Chinese Association of Chest Physicians (CACP) are widely used in China. We compared the key similarities and differences of these recommendations and interpreted the key updates. The ATS/ERS 2019 updates expanded the scope of indications for spirometry and recommended the contraindications based on the pathophysiological perspective, while contraindications recommended by the CTS were based on the severity of contraindications. ISO 26782∶2009 standards were applied by the ATS/ERS 2019 to evaluate the performance quality (reliance for accuracy, repeatability, .) of spirometers, while standards adopted 24/26 waves suggested by the ATS 1994 was used by the CTS. The ATS/ERS 2019 also included the performance quality control criteria for 3-L calibration syringe, operator training and attainment and maintenance of competency, grade"U", system warning messages, instructions to patients, and standardized operator comments. Some of these criteria in the CTS were not explained in detail. However, the CTS/CACP emphasized that the spirometry record should report the indices of forced inspiratory phase and small airway function, those are not clearly required in the ATS/ERS 2019. In comparison, the ATS/ERS 2019 has stricter criteria for FEV and FVC acceptability than the CTS and more detailed explanations. Those outstanding parts are worth referencing for the updated version of the CTS in the future, while the criteria that combine our own conditions need to be retained and popularized.
美国胸科学会（ATS）和欧洲呼吸学会（ERS）于2019年联合更新了肺量计标准化内容。中国胸科学会（CTS）和/或中国医师协会胸外科医师分会（CACP）推荐的类似肺量计技术标准在中国广泛使用。我们比较了这些建议的主要异同点，并解读了关键更新内容。ATS/ERS 2019年的更新扩大了肺量计检查的适应症范围，并从病理生理学角度推荐了禁忌症，而CTS推荐的禁忌症则基于禁忌症的严重程度。ATS/ERS 2019采用ISO 26782∶2009标准来评估肺量计的性能质量（准确性可靠性、重复性等），而CTS采用的是ATS 1994年建议的24/26波标准。ATS/ERS 2019还包括3L校准注射器的性能质量控制标准、操作人员培训及能力的获得与维持、“U”级、系统警告信息、对患者的指导以及标准化的操作人员注释。CTS中的一些标准未详细解释。然而，CTS/CACP强调肺量计记录应报告用力吸气相和小气道功能指标，而ATS/ERS 2019中并未明确要求这些。相比之下，ATS/ERS 2019对FEV和FVC可接受性的标准比CTS更严格，解释也更详细。这些突出部分值得CTS未来更新版本参考，而结合我国自身情况的标准则需要保留和推广。
