Sackner M A, Rao A S, Birch S, Atkins N, Gibbs L, Davis B
Chest. 1982 Sep;82(3):272-8. doi: 10.1378/chest.82.3.272.
The purpose of this investigation was to assess the effectiveness of the time-volume and flow-volume components of the forced vital capacity measured by simultaneous spirometry, respiratory inductive plethysmography, and body plethysmography in detecting small airway disease. Spirometry measured the exit of gas from the lungs, whereas body plethysmography measured both the exit of gas and alveolar gas compression. Respiratory inductive plethysmography, which reflected change in thoracic volume, provided semi-quantitative data f both gas exit and alveolar gas compression which generally lay between spirometry and body plethysmography. In nine nonsmokers and 12 smokers (six with small airway disease as defined by abnormal closing volumes and alveolar uniformity), analysis of forced vital capacity revealed that the only test which differentiated nonsmokers from smokers was the higher spirometric estimation of maximum expiratory flow measured at 25 percent VC in nonsmokers. Combining flow measure at the mouth with volume referenced to change in alveolar gas volume as measured by body or respiratory inductive plethysmography did not differentiate nonsmokers from smokers. Moment analysis performed of forced vital capacity with all of the three devices did not distinguish nonsmokers from smokers. The data in this study and a review of other investigations indicate that the time-volume and flow-volume components of the forced vital capacity on air breathing are not very sensitive in detecting early lung disease in smokers.
本研究的目的是评估通过同步肺量计、呼吸感应体积描记法和体容积描记法测量的用力肺活量的时间-容积和流量-容积成分在检测小气道疾病方面的有效性。肺量计测量肺内气体的呼出,而体容积描记法测量气体呼出和肺泡气体压缩。呼吸感应体积描记法反映胸廓容积变化,提供了气体呼出和肺泡气体压缩的半定量数据,通常介于肺量计和体容积描记法之间。在9名不吸烟者和12名吸烟者(6名有小气道疾病,定义为闭合容积异常和肺泡均匀性异常)中,用力肺活量分析显示,唯一能区分不吸烟者和吸烟者的测试是不吸烟者在25%肺活量时通过肺量计对最大呼气流量的较高估计值。将口腔流量测量与通过体容积描记法或呼吸感应体积描记法测量的与肺泡气体容积变化相关的容积相结合,无法区分不吸烟者和吸烟者。使用所有三种设备对用力肺活量进行矩分析也无法区分不吸烟者和吸烟者。本研究的数据以及对其他研究的综述表明,在检测吸烟者的早期肺部疾病方面,静息呼吸时用力肺活量的时间-容积和流量-容积成分不太敏感。