Bjørtuft O, Johansen B, Boe J, Foerster A, Holter E, Geiran O
Dept of Thoracic Medicine, Rikshospitalet, University of Oslo, Norway.
Eur Respir J. 1993 May;6(5):705-8.
Eight single lung transplant recipients with emphysema, aged 40-58 yrs, have been followed up for 90 patient months. Starting 2-4 weeks postoperatively, they recorded their forced vital capacity (FVC), and forced expiratory volume in one second (FEV1), at a fixed time every morning using a Micro Spirometer. They were instructed to contact the hospital if the FVC or FEV1 displayed a persistent (two days or more) decrease of 10%, compared with the average values during the last seven days. Transbronchial biopsies (TBB) were performed regularly in the follow-up, and whenever the patients had respiratory symptoms, or the FVC or FEV1 displayed a persistent decline of more than 10%. We performed 59 TBBs, and 23 biopsy specimens showed rejection. The FVC and FEV1 values on the TBB day were compared with the mean values of the 7 previous days. FVC and FEV1, associated with negative TBBs (16 events), showed no significant changes. However, FVC and FEV1 decreased significantly (p < 0.001, paired t-test) during rejections (mean percentage change 14 and 21% respectively, range +8% to -53%). In 16 of the 23 rejections, the FEV1 decreased by > 10%. We recommend the use of daily home spirometry when monitoring single lung recipients with emphysema, and suggest that a persistent 10% decrease in FEV1 or FVC for at least two days is an indication for hospital admission and possible TBB.
8例年龄在40 - 58岁的肺气肿单肺移植受者接受了90个患者月的随访。术后2 - 4周开始，他们每天早晨固定时间使用微型肺活量计记录用力肺活量（FVC）和一秒用力呼气容积（FEV1）。如果FVC或FEV1与过去7天的平均值相比持续（两天或更长时间）下降10%，则指示他们联系医院。在随访期间以及患者出现呼吸道症状或FVC或FEV1持续下降超过10%时定期进行经支气管活检（TBB）。我们进行了59次TBB，其中23份活检标本显示有排斥反应。将TBB当天的FVC和FEV1值与前7天的平均值进行比较。与阴性TBB（16例）相关的FVC和FEV1无显著变化。然而,在排斥反应期间，FVC和FEV1显著下降（配对t检验，p < 0.001）（平均变化百分比分别为14%和21%，范围为 +8%至 -53%）。在23例排斥反应中的16例中，FEV1下降超过 > 使用每日家庭肺活量测定法监测肺气肿单肺移植受者，并且表明FEV1或FVC持续下降10%至少两天是入院和可能进行TBB的指征。 10%。我们建议在监测肺气肿单肺移植受者时使用每日家庭肺活量测定法，并表明FEV1或FVC持续下降10%至少两天是入院和可能进行TBB的指征。
