在慢性阻塞性肺疾病负担（BOLD）研究中，用力肺活量（FVC）与第一秒用力呼气容积（FEV）在识别慢性气流受限和肺量计测定受限方面的一致性。
Concordance between FVC and FEV for identifying chronic airflow obstruction and spirometric restriction in the Burden of Obstructive Lung Disease (BOLD) study.
作者信息
Knox-Brown Ben, Potts James, Franssen Frits M E, Nielsen Rune, Denguezli Meriam, Rotevatn Anders Ørskov, Juvekar Sanjay K, Cherkaski Hamid Hacene, Studnicka Michael, Sylvester Karl Peter, Mortimer Kevin, Bateman Eric D, Janson Christer, Malinovschi Andrei, Seemungal Terence, Koul Parvaiz, Mannino David, Mahesh Padukudru Anand, Jogi Rain, Mejza Filip, Al Ghobain Mohammed, Paraguas Stefanni Nonna M, Welte Tobias, Wouters Emiel, Gislason Thorarinn, Harrabi Imed, Dias Hermínia, Obaseki Daniel O, Kocabas Ali, Barbara Cristina, Cardoso Joao, Agarwal Dhiraj, Nafees Asaad Ahmed, Rodrigues Fatima, Garcia-Larsen Vanessa, Erhabor Gregory E, Loh Li-Cher, Amaral Andre F S
机构信息
Imperial College London National Heart and Lung Institute, London, UK
Cambridge Respiratory Physiology, Royal Papworth and Cambridge University Hospitals NHS FT, Cambridge, UK.
出版信息
BMJ Open Respir Res. 2025 Jul 13;12(1):e002355. doi: 10.1136/bmjresp-2024-002355.
INTRODUCTION
We investigated whether the forced expiratory volume in 6 s (FEV) can be used as a surrogate for the forced vital capacity (FVC).
METHODS
The Burden of Obstructive Lung Disease is a multinational cohort study. At baseline, data were collected from adults, aged 40 years or older, from 41 sites across 34 countries. Participants from 18 sites were followed-up after a median of 8.3 years. Participants who completed the study core questionnaire and had acceptable post-bronchodilator spirometry were included. We performed receiver operating characteristic analyses to measure the ability of FEV/FEV less than the lower limit of normal (LLN) to correctly classify FEV/FVC less than the LLN, and FEV less than the LLN to correctly classify FVC less than the LLN. We used multilevel regression analyses to assess the association of discordant measurements with respiratory symptoms, quality of life and lung function decline.
RESULTS
At baseline, 28 604 participants were included. 53% were female (15 060). 10% (2876) had chronic airflow obstruction for FEV/FVC, compared with 9% (2704) for FEV/FEV. 37% (10 637) had spirometric restriction for FVC, compared with 35% (9978) for FEV. The FEV/FEV had excellent accuracy in identifying FEV/FVC less than the LLN (area under the curve (AUC): 0.90, 95% CI, 0.89 to 0.91, κ coefficient 0.82). The FEV also had excellent agreement in identifying FVC less than the LLN (AUC: 0.95, 95% CI, 0.94 to 0.95, κ coefficient 0.90). Discordant reductions in FEV/FEV (1%, 345) and FEV (1%, 309) were associated with greater odds of having respiratory symptoms and a lower physical quality of life. 3870 participants were followed up. Those with discordant reductions in FEV/FEV and FEV were more likely to have chronic airflow obstruction and spirometric restriction at follow-up.
CONCLUSIONS
There is strong agreement between the FVC and FEV in the identification of chronic airflow obstruction and spirometric restriction.
引言
我们研究了6秒用力呼气容积（FEV）是否可作为用力肺活量（FVC）的替代指标。
方法
慢性阻塞性肺疾病负担研究是一项跨国队列研究。在基线时，收集了来自34个国家41个研究点的40岁及以上成年人的数据。18个研究点的参与者在中位时间8.3年后接受了随访。纳入完成研究核心问卷且支气管扩张剂后肺功能测定结果可接受的参与者。我们进行了受试者工作特征分析，以测量FEV/FEV低于正常下限（LLN）时正确分类FEV/FVC低于LLN的能力，以及FEV低于LLN时正确分类FVC低于LLN的能力。我们使用多水平回归分析来评估不一致测量结果与呼吸道症状、生活质量和肺功能下降之间的关联。
结果
在基线时，纳入了28604名参与者。53%为女性（15060名）。10%（2876名）的FEV/FVC存在慢性气流受限，而FEV/FEV为9%（2704名）。37%（10637名）的FVC存在肺功能测定受限，而FEV为35%（9978名）。FEV/FEV在识别FEV/FVC低于LLN方面具有出色的准确性（曲线下面积（AUC）：0.90，95%CI，0.89至0.91，κ系数0.82）。FEV在识别FVC低于LLN方面也具有出色的一致性（AUC：0.95，95%CI，0.94至0.95，κ系数0.90）。FEV/FEV（1%，345名）和FEV（1%，309名）的不一致降低与出现呼吸道症状的几率增加和身体生活质量降低相关。对3870名参与者进行了随访。FEV/FEV和FEV不一致降低的参与者在随访时更有可能出现慢性气流受限和肺功能测定受限。
结论
FVC和FEV在识别慢性气流受限和肺功能测定受限方面具有很强的一致性。
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