Brand P, Tuch T, Manuwald O, Bischof W, Heinrich J, Wichmann H E, Beinert T, Heyder J
GSF-Forschungszentrum für Umwelt und Gesundheit, Projekt Inhalation and Institut für Epidemiologie, Oberschleissheim, FRG.
Eur Respir J. 1994 Oct;7(10):1830-8. doi: 10.1183/09031936.94.07101830.
The broadening of inhaled aerosol boluses (aerosol bolus dispersion) during respiration provides a noninvasive measure of convective gas mixing in the lungs. In this study, the sensitivity and specificity of this technique for the diagnosis of early lung impairment due to cigarette smoking was evaluated. Two hundred and sixteen randomly selected subjects (126 smokers and 90 nonsmokers) were investigated with aerosol dispersion in comparison to conventional lung function tests. The cumulative cigarette consumption of the subjects was quantified by "pack-years" (PY). Smokers were classified into the following groups: 0 < PY < or = 10; 10 < PY < or = 20; 20 < PY < or = 30; and PY > 30. Forced expiratory volume in one second (FEV1), maximal expiratory flow at 25, 50 and 75% vital capacity (MEF25, MEF50 and MEF75) decreased significantly with increasing cigarette consumption. In comparison to nonsmokers, FEV1 was significantly reduced in smokers of 10 < PY < or = 30, and MEF75 was significantly reduced in smokers of PY > 20. Aerosol bolus dispersion increased with increasing PY. For all groups of smokers, even those with PY < 10, bolus dispersion was significantly increased in comparison to lifelong nonsmokers, indicating alterations in convective gas mixing in the lungs. Calculation of receiver operating characteristics for the lung function parameters under consideration showed that bolus dispersion has a higher sensitivity and specificity than conventional lung function parameters. Hence, the aerosol bolus dispersion test could be a promising epidemiological tool to study early abnormalities in intrapulmonary gas mixing due to environmental factors.
呼吸过程中吸入气溶胶团块的扩展（气溶胶团块扩散）为肺部对流气体混合提供了一种非侵入性测量方法。在本研究中，评估了该技术对吸烟所致早期肺损伤诊断的敏感性和特异性。与传统肺功能测试相比，对216名随机选择的受试者（126名吸烟者和90名非吸烟者）进行了气溶胶扩散研究。受试者的累积吸烟量通过“包年”（PY）进行量化。吸烟者被分为以下几组：0 < PY ≤ 10；10 < PY ≤ 20；20 < PY ≤ 30；以及PY > 30。一秒用力呼气量（FEV1）、肺活量25%、50%和75%时的最大呼气流量（MEF25、MEF50和MEF75）随着吸烟量增加而显著降低。与非吸烟者相比，PY在10 < PY ≤ 30的吸烟者中FEV1显著降低，在PY > 20的吸烟者中MEF75显著降低。气溶胶团块扩散随PY增加而增加。对于所有吸烟者组，即使是PY < 10的那些组，与终生不吸烟者相比，团块扩散也显著增加，表明肺部对流气体混合发生了改变。对所考虑的肺功能参数进行受试者工作特征计算表明，团块扩散比传统肺功能参数具有更高的敏感性和特异性。因此，气溶胶团块扩散试验可能是一种有前景的流行病学工具，用于研究环境因素导致的肺内气体混合早期异常情况。
