Jones K P, Mullee M A
Primary Medical Care Group, Faculty of Medicine, University of Southampton, UK.
Respir Med. 1995 Nov;89(10):657-63. doi: 10.1016/0954-6111(95)90132-9.
It is important that new types of spirometer for widespread clinical use are pragmatically evaluated in primary care. This study compared measurements taken by a new portable Fleisch pneumotachograph spirometer (known as the Escort) with those of the commonly used mini-Wright peak flow meter and the Micromed Pocket turbine spirometer. A pragmatic study was conducted in two phases during routine surgeries at Aldermoor Health Centre, Southampton. Phase I compared the new spirometer with the mini-Wright peak flow meter and Phase 2 compared the new spirometer and the turbine spirometer. One hundred patients aged 5-88 years (56 patients with a history of chronic respiratory complaints and 44 patients without) entered Phase 1, and 100 patients aged 6-82 years (62 patients with a history of chronic respiratory complaints and 38 patients without) entered Phase 2. Each patient contributed only once to each phase, but some entered both phases on separate occasions. Ninety-five percent limits of agreement (mean +/- SD) were wide for all comparisons. Graphical plots revealed trends towards higher Escort values as mean values rose compared with both mini-Wright and turbine readings for peak expiratory flow rate and forced expiratory volume in one second. Possible over-reading of peak expiratory flow rate with the mini-Wright meter at low mean values was also seen. Readings taken with these different types of meter cannot be interchanged with confidence in clinical practice. The clinical significance of the theoretically more accurate measures of lung function produced with the new meter, and indeed of spirometry itself, needs further investigation.
对广泛应用于临床的新型肺活量计在基层医疗中进行实际评估非常重要。本研究将一种新型便携式弗莱施呼吸流速仪肺活量计(称为Escort)的测量结果与常用的微型赖特峰值流量计和迈德口袋式涡轮肺活量计的测量结果进行了比较。在南安普敦的奥尔德莫尔健康中心进行常规手术期间,分两个阶段开展了一项实际研究。第一阶段将新型肺活量计与微型赖特峰值流量计进行比较,第二阶段将新型肺活量计与涡轮肺活量计进行比较。100名年龄在5至88岁之间的患者(56名有慢性呼吸道疾病史,44名无慢性呼吸道疾病史)进入第一阶段,100名年龄在6至82岁之间的患者(62名有慢性呼吸道疾病史,38名无慢性呼吸道疾病史)进入第二阶段。每位患者在每个阶段仅参与一次,但有些患者在不同时间参与了两个阶段。所有比较的一致性界限(均值±标准差)的95%范围都很宽。图形显示,与微型赖特和涡轮流量计的呼气峰值流速和一秒用力呼气量读数相比,随着平均值升高,Escort的值有升高趋势。在低平均值时,还发现微型赖特流量计可能对呼气峰值流速读数过高。在临床实践中,不能放心地互换使用这些不同类型仪器的读数。新型仪器所产生的理论上更准确的肺功能测量值以及肺活量测定本身的临床意义需要进一步研究。