Lam S, Abboud R T, Chan-Yeung M, Tan F
Am Rev Respir Dis. 1981 Feb;123(2):234-7. doi: 10.1164/arrd.1981.123.2.234.
Flow-volume curves with air and helium, and spirometry were obtained in 423 subjects during epidemiologic health surveys; subjects were divided into 4 groups: nonsmokers and smokers not exposed to air pollutants at work, and nonsmoking and smoking grain elevator workers. The data obtained from 78 healthy nonsmokers who were not exposed to any air contaminants at work and had no respiratory symptoms were used to develop "normal" prediction equations for each of the following parameters: forced expiratory volume in one second (FEV1), maximal mid-expiratory flow, maximal expiratory flow at 50% of vital capacity while breathing air (Vmax50), the increase in Vmax50 after breathing a mixture of helium and O2 (delta Vmax50), and the volume of isoflow (VisoV). The prediction equations thus obtained from normal nonsmokers agreed with those published in the literature. The coefficient of variation was higher for delta Vmax50 (40.7%) and VisoV (57.6%) than for FEV1 (17.7%) or Vmax50 (27.7%). Comparison of results in smokers and nonsmokers who were not exposed to any air contaminants at work indicated that Vmax50 was the best test for discriminating the effect of cigarette smoking, whereas delta Vmax50 and VisoV were not significantly different. The FEV1 was the best discriminator of the effects of grain dust. There was poor concordance among FEV1, Vmax50, and delta Vmax50 or VisoV. We concluded that FEV1 and Vmax50 are more useful parameters than are delta Vmax50 and VisoV for detecting ventilatory abnormalities in a smoking, working population and in grain elevator workers. The results suggest that the addition of the more time-consuming test, the helium flow-volume curve, is unlikely to contribute any further useful information among the populations surveyed.
在423名受试者进行流行病学健康调查期间，获取了他们吸入空气和氦气时的流量-容积曲线以及肺量计测量结果；受试者被分为4组：不吸烟者、工作中未接触空气污染物的吸烟者、不吸烟的谷物升降机工人以及吸烟的谷物升降机工人。从78名健康且工作中未接触任何空气污染物且无呼吸道症状的不吸烟者获得的数据，被用于为以下每个参数建立“正常”预测方程：一秒用力呼气量（FEV1）、最大呼气中期流量、呼吸空气时肺活量50%时的最大呼气流量（Vmax50）、吸入氦气和氧气混合物后Vmax50的增加量（δVmax50）以及等流量容积（VisoV）。由此从不吸烟正常人获得的预测方程与文献中发表的方程一致。δVmax50（40.7%）和VisoV（57.6%）的变异系数高于FEV1（17.7%）或Vmax50（27.7%）。对工作中未接触任何空气污染物的吸烟者和不吸烟者的结果比较表明，Vmax50是区分吸烟影响的最佳测试指标，而δVmax50和VisoV无显著差异。FEV1是谷物粉尘影响的最佳区分指标。FEV1、Vmax50与δVmax50或VisoV之间的一致性较差。我们得出结论，对于检测吸烟的在职人群和谷物升降机工人的通气异常，FEV1和Vmax50比δVmax50和VisoV更有用。结果表明，增加耗时更长的氦气流量-容积曲线测试，在被调查人群中不太可能提供更多有用信息。
