Lebecque P, Kiakulanda P, Coates A L
Department of Pediatric Pulmonology, St. Luc Clinics, Catholic University of Louvain, Brussels, Belgium.
Pediatr Pulmonol. 1993 Jul;16(1):19-22. doi: 10.1002/ppul.1950160105.
The use of spirometry in the assessment of children with asthma is taking on new importance with the realization that considerable airway obstruction may exist in the absence of clinically detectable abnormalities. There has been controversy over the value and relative sensitivity of various spirometry indices. This study evaluated the forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), forced expired volume in 1 second (FEV1), and the ratio between the FEV1 and the forced vital capacity (FVC) in 100 asthmatic children aged 6-17 years, 29 of whom were wheezing at the time of the evaluation. All children with clinical wheezing had a FEV25-75 < 2 standard deviations (SD) below the mean (-2 SD), whereas 8 had a normal FEV1. The majority of the wheezing children had abnormalities of all 3 indices, whether expressed as < or = -2 SD or, in the case of the FEV1/FVC, arbitrarily taken as < 80%. Sixty-seven children of the entire study group had at least 1 abnormal spirometric index, but 38 of these had no clinical abnormalities. Twelve children had a reduced FEF25-75 as the only abnormality. These results suggest that FEF25-75 is a sensitive index of airway obstruction.
随着人们认识到在无临床可检测异常的情况下可能存在相当程度的气道阻塞，肺量计在哮喘儿童评估中的应用正变得愈发重要。关于各种肺量计指标的价值和相对敏感性一直存在争议。本研究评估了100名6至17岁哮喘儿童的肺活量25%至75%之间的用力呼气流量（FEF25 - 75）、1秒用力呼气容积（FEV1）以及FEV1与用力肺活量（FVC）的比值，其中29名儿童在评估时正在喘息。所有临床喘息的儿童FEF25 - 75均低于平均值2个标准差（SD）（-2 SD），而8名儿童FEV1正常。大多数喘息儿童的所有3项指标均异常，无论是表示为<或= -2 SD，还是就FEV1/FVC而言，任意取值<80%。整个研究组中有67名儿童至少有1项肺量计指标异常，但其中38名无临床异常。12名儿童仅FEF25 - 75降低作为唯一异常。这些结果表明FEF25 - 75是气道阻塞的敏感指标。
