Keskinen H, Piirilä P, Nordman H, Nurminen M
Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland.
Clin Physiol. 1996 Nov;16(6):633-43. doi: 10.1111/j.1475-097x.1996.tb00740.x.
Diagnosis of occupational asthma is verified by inhalation challenge testing when frequent monitoring of peak expiratory flow (PEF) or forced expiratory volume in 1 s (FEV1) is needed. FEV1 measurements also allow frequent monitoring of changes in small airways. For the follow-up of lung function of suspected occupational asthma, a reliable, personal and mobile device is needed. We studied the accuracy of a pocket-sized spirometer, Micro Plus Spirometer (MP), compared with our former combination of two devices, i.e. the values of forced expiratory volume in 1 s (FEV1) with those measured with the Vitalograph bellow spirometer (V); and the peak expiratory flow (PEF) values with the values obtained with a Wright PEF meter (W). In healthy control subjects, the values of FEV1 obtained with Micro Plus correspond well to those obtained using a bellow spirometer (R = 0.97) and the mean difference (MP-V) was -0.06 1 irrespective of the mean FEV1 value. W gives smaller PEF values than the MP; the mean difference in PEF (MP-W) was 44 1 min-1, but the values increased linearly with increasing flow. The poor relation between PEF values might be based on the low reliability of the Wright device. In patient follow-up, the FEV1 values measured with MP and V showed a good correlation (R = 0.99). The PEF values in patients increase linearly measured with W vs. MP with increasing flow values. In conclusion, we found the pocket-sized spirometer a handy and useful device for monitoring bronchial challenge procedures in patients with suspected occupational asthma. The number of exhalations during the challenge test follow-up is lessened when FEV1 and peak expiratory flow (PEF) can be measured simultaneously.
当需要频繁监测呼气峰值流速（PEF）或1秒用力呼气容积（FEV1）时，职业性哮喘的诊断通过吸入激发试验来证实。FEV1测量还可对小气道变化进行频繁监测。对于疑似职业性哮喘患者的肺功能随访，需要一种可靠、便携的个人设备。我们研究了一款袖珍肺活量计Micro Plus Spirometer（MP）与我们之前使用的两种设备组合（即1秒用力呼气容积（FEV1）值与使用伟康肺量计（V）测量的值；以及呼气峰值流速（PEF）值与使用赖特PEF计（W）获得的值）相比的准确性。在健康对照受试者中，Micro Plus获得的FEV1值与使用肺量计获得的值非常吻合（R = 0.97），平均差异（MP - V）为 -0.06 L，与平均FEV1值无关。W得出的PEF值比MP小；PEF的平均差异（MP - W）为44 L/min，但这些值随流速增加呈线性增加。PEF值之间的相关性较差可能是基于赖特设备的可靠性较低。在患者随访中，用MP和V测量的FEV1值显示出良好的相关性（R = 0.99）。患者的PEF值在用W与MP测量时随流速增加呈线性增加。总之，我们发现这款袖珍肺活量计是监测疑似职业性哮喘患者支气管激发程序的方便且有用的设备。当可以同时测量FEV1和呼气峰值流速（PEF）时，激发试验随访期间的呼气次数会减少。
