Pern P O, Love R G, Wightman A J, Soutar C A
Bull Eur Physiopathol Respir. 1984 Nov-Dec;20(6):487-93.
From a longitudinal study of respiratory health of coalminers, we have selected 29 smokers and 12 non-smokers with the greatest decline in FEV1 over a ten year period and have compared them with 29 smokers and 14 non-smokers with the least decline. In order to identify syndromes associated with rapid decline in FEV1, we made a clinical and physiological examination of these men five years after the end of the ten year period of measured FEV1 decline. There was no substantial difference in mean lung function between rapid and slow decliners at the time of examination. However, the rapid decliners as a group had an excess of respiratory symptoms, a significantly lower mid-expiratory flow rate and an excess of early and mid-inspiratory crackles on auscultation. Lung function was only abnormal by conventional standards in one third of the smoking rapid decliners. These men had either airflow obstruction (accompanied in three cases by evidence of emphysema) or a concentric reduction of both FEV1 and FVC. There was no excess of atopy nor of history of childhood respiratory illness in rapid decliners. We conclude that it is likely to be difficult to detect the rapid decliners among working men on the basis of a single examination and that at present detection must depend on serial measurements of FEV1.
通过对煤矿工人呼吸健康的一项纵向研究，我们挑选出了在十年期间FEV1下降幅度最大的29名吸烟者和12名非吸烟者，并将他们与下降幅度最小的29名吸烟者和14名非吸烟者进行了比较。为了确定与FEV1快速下降相关的综合征，在测量FEV1下降的十年期结束五年后，我们对这些人进行了临床和生理检查。在检查时，FEV1快速下降者和缓慢下降者之间的平均肺功能没有实质性差异。然而，作为一个群体，FEV1快速下降者有过多的呼吸道症状、显著更低的呼气中期流速以及听诊时有过多的早期和中期吸气性啰音。按照传统标准，只有三分之一吸烟的FEV1快速下降者的肺功能异常。这些人要么有气流阻塞（三例伴有肺气肿证据），要么FEV1和FVC均呈同心性降低。FEV1快速下降者中特应性疾病或儿童期呼吸道疾病史并无过多情况。我们得出结论，基于单次检查在在职男性中检测出FEV1快速下降者可能很困难，目前检测必须依赖于FEV1的系列测量。
