Guezguez Fatma, Ghannouchi Inès, Sayhi Amani, Charfedi Emna, Yahyaoui Arwa, Rouatbi Sonia, Ben Saad Helmi
Heart Failure (LR12SP09) Research Laboratory, Farhat Hached Hospital, Sousse, Tunisia.
Tunis Med. 2023 Mar 5;101(3):323-333.
The diagnosis and management of the most prevalent chronic respiratory diseases partially rely on parameters obtained from pulmonary functional tests (PFTs), including spirometry, plethysmography, and carbon monoxide diffusion capacity (DLCO) measurement. In practice, the interpretation of PFTs' parameters is based on international recommendations issued by renowned scientific societies such as the American Thoracic Society (ATS) and the European Respiratory Society (ERS). The interpretation standards for PFTs established by ATS/ERS in 2005 were updated in 2022. According to the ATS/ERS-2022 standards, the interpretation of PFTs can be summarized in five steps. The first step involves comparing the determined parameters with those observed in a reference population of healthy individuals. This step helps determine whether the determined parameters are low, normal, or elevated. The second step aims to identify potential ventilatory impairments, such as obstructive and/or restrictive ventilatory impairments, which can be observed in certain chronic respiratory or extrarespiratory diseases. The third step involves assessing the severity of the identified ventilatory impairment or the decrease in DLCO. The fourth step entails evaluating the response to bronchodilator testing, if performed. Finally, if previous PFTs results are available, it is important to identify significant changes in certain PFTs parameters over time by comparing current and previous results. This clinical practice guide provides a comprehensive synthesis of the different steps in PFTs interpretation, taking into account the recommendations from ATS/ERS-2022.
最常见的慢性呼吸道疾病的诊断和管理部分依赖于从肺功能测试(PFTs)获得的参数,包括肺活量测定、体积描记法和一氧化碳弥散量(DLCO)测量。在实践中,PFTs参数的解读基于美国胸科学会(ATS)和欧洲呼吸学会(ERS)等著名科学协会发布的国际建议。2005年由ATS/ERS制定的PFTs解读标准于2022年进行了更新。根据ATS/ERS-2022标准,PFTs的解读可概括为五个步骤。第一步是将测定的参数与健康个体参考人群中观察到的参数进行比较。这一步有助于确定测定的参数是低、正常还是升高。第二步旨在识别潜在的通气功能障碍,如阻塞性和/或限制性通气功能障碍,这在某些慢性呼吸道或呼吸道外疾病中可见。第三步是评估已识别的通气功能障碍的严重程度或DLCO的降低情况。第四步需要评估如果进行了支气管扩张试验的反应。最后,如果有以前的PFTs结果,通过比较当前和以前的结果来识别某些PFTs参数随时间的显著变化很重要。本临床实践指南综合了PFTs解读的不同步骤,并考虑了ATS/ERS-2022的建议。