Fairshter R D, Wilson A F
Am Rev Respir Dis. 1981 Jan;123(1):3-7. doi: 10.1164/arrd.1981.123.1.3.
We studied the relationship between sites of airflow limitation and severity of chronic obstructive pulmonary disease. Pre- and postbronchodilator physiologic testing was performed in 30 subjects with chronic airflow obstruction (CAO). Pulmonary function, including the increase in maximal expiratory flow at 50% of vital capacity after helium-oxygen breathing (delta VEmax50), was reduced before and after inhalation of 1.3 mu mg of metaproterenol. Significant correlations were present between values for delta VEmax50 and measurements of expiratory flow (p < 0.001). In subjects with severe CAO (one-second forced expiratory volume less than or equal to 1.2 L; percentage ratio of one-second forced expiratory volume to forced vital capacity < 50%), delta VEmax50 was always abnormally decreased. An inverse relationship was present between initial delta VEmax50 and changes in delta VEmax50 after inhalation of metaproterenol (p < 0.001). These results suggest that the site of airflow limitation becomes progressively more peripheral as CAO worsens, and that severe CAO is usually associated with peripheral sites of airflow limitation.
我们研究了气流受限部位与慢性阻塞性肺疾病严重程度之间的关系。对30例慢性气流阻塞（CAO）患者进行了支气管扩张剂使用前后的生理测试。在吸入1.3μg异丙喘宁前后，包括氦氧呼吸后肺活量50%时最大呼气流量的增加量（δVEmax50）在内的肺功能均降低。δVEmax50值与呼气流量测量值之间存在显著相关性（p<0.001）。在重度CAO患者（一秒用力呼气容积小于或等于1.2L；一秒用力呼气容积与用力肺活量的百分比比值<50%）中，δVEmax50总是异常降低。吸入异丙喘宁后，初始δVEmax50与δVEmax50的变化之间存在负相关关系（p<0.001）。这些结果表明，随着CAO病情加重，气流受限部位逐渐更加外周化，并且重度CAO通常与外周气流受限部位相关。
