Brodkin C A, Barnhart S, Anderson G, Checkoway H, Omenn G S, Rosenstock L
Occupational and Environmental Medicine Program, University of Washington, Seattle 98104.
Am Rev Respir Dis. 1993 Jul;148(1):32-7. doi: 10.1164/ajrccm/148.1.32.
Studies of respiratory questionnaire efficacy have emphasized reliability of responses; few have validated symptom response with objective measures of pulmonary function. To determine whether respiratory symptoms are associated with diminished pulmonary function, symptoms reported on the American Thoracic Society (ATS-DLD-78A) questionnaire were correlated cross-sectionally with measured spirometric volumes in 816 asbestos-exposed workers. Cough, phlegm, wheeze, and dyspnea were inversely related to pulmonary function. Cough, phlegm, and chronic bronchitis were associated with a 2 to 8% reduction (p < 0.001) in predicted values for forced vital capacity (FVC) and forced expiratory volume (FEV1); wheeze and dyspnea were clinically more significant, with an 11 to 17% reduction (p < 0.001). Wheeze, dyspnea, and roentgenographic fibrosis were all significant independent predictors of risk for restrictive impairment. These results support the validity of the ATS questionnaire as an epidemiologic tool and emphasize the importance of clinical history in assessing respiratory status.
对呼吸问卷有效性的研究着重于回答的可靠性；很少有研究通过肺功能的客观测量来验证症状反应。为了确定呼吸症状是否与肺功能减退相关，对816名接触石棉的工人进行了研究，将美国胸科学会（ATS-DLD-78A）问卷中报告的症状与通过肺活量测定法测得的肺容积进行横断面相关性分析。咳嗽、咳痰、喘息和呼吸困难与肺功能呈负相关。咳嗽、咳痰和慢性支气管炎与用力肺活量（FVC）和第一秒用力呼气容积（FEV1）预测值降低2%至8%相关（p<0.001）；喘息和呼吸困难在临床上更为显著，降低了11%至17%（p<0.001）。喘息、呼吸困难和X线纤维化都是限制性损伤风险的重要独立预测因素。这些结果支持了ATS问卷作为一种流行病学工具的有效性，并强调了临床病史在评估呼吸状况中的重要性。
