Small airway function measured using forced expiratory flow between 25% and 75% of vital capacity and its relationship to airflow limitation in symptomatic ever-smokers: a cross-sectional study.
Small airway function measured using forced expiratory flow between 25% and 75% of vital capacity and its relationship to airflow limitation in symptomatic ever-smokers: a cross-sectional study.
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DOI：
10.1136/bmjresp-2022-001385
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发表时间：
2022-10
影响因子：
4.1
通讯作者：
中科院分区：
文献类型：
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慢性阻塞性肺疾病（COPD）的诊断及其严重程度是通过传统的肺活量测定参数(分别为1秒用力呼气量（FEV1)/用力肺活量（FVC）和FEV1）分级的，但这些参数被认为对识别早期病理不敏感。测量小气道功能，包括用力呼气流量在肺活量的25% - 75%之间（FEF25-75），在COPD的早期阶段可能更有价值。本研究旨在确定低FEF25-75在有和没有气流限制（AL）的吸烟者中的患病率，并确定FEF25-75是否与AL严重程度有关。回顾性分析1458例临床怀疑患有慢性阻塞性肺病的吸烟者肺功能资料。低FEF25-75为z-score<−0.8345，AL为FEV1/FVC z-score<−1.645。使用FEV1 z-score评估AL的严重程度。参与者分为三组：FEF25-75/无AL（正常FEF25-75/AL−）；低FEF25-75/ no AL（低FEF25-75/AL−）和低FEF25-75/AL（低FEF25-75/AL+）。99.9%的AL患者和50%的无AL患者存在低FEF25-75。低FEF25-75/AL -组患者的肺活量测量（包括FEV1 FEF25-75/FVC和FEV3/FVC）低于正常FEF25-75/AL -组。FEF25-75随AL严重程度降低。逻辑回归模型表明，在没有AL的情况下，即使考虑吸烟史，低FEF25-75的存在也与较低的FEV1和FEV1/FVC相关。低FEF25-75是传统肺活量测定AL患者的一种生理特征，当肺活量测定在“正常范围”时，可能反映了小气道损伤的早期证据。FEF25-75可能确定了一组有早期病理性肺损伤证据的患者，他们需要仔细监测并加强早期干预以消除进一步的肺损伤。
Chronic obstructive pulmonary disease (COPD) is diagnosed and its severity graded by traditional spirometric parameters (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and FEV1, respectively) but these parameters are considered insensitive for identifying early pathology. Measures of small airway function, including forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), may be more valuable in the earliest phases of COPD. This study aimed to determine the prevalence of low FEF25-75 in ever-smokers with and without airflow limitation (AL) and to determine whether FEF25-75 relates to AL severity. A retrospective analysis of lung function data of 1458 ever-smokers suspected clinically of having COPD. Low FEF25-75 was defined by z-score<−0.8345 and AL was defined by FEV1/FVC z-scores<−1.645. The severity of AL was evaluated using FEV1 z-scores. Participants were placed into three groups: normal FEF25-75/ no AL (normal FEF25-75/AL−); low FEF25-75/ no AL (low FEF25-75/AL−) and low FEF25-75/ AL (low FEF25-75/AL+). Low FEF25-75 was present in 99.9% of patients with AL, and 50% of those without AL. Patients in the low FEF25-75/AL− group had lower spirometric measures (including FEV1 FEF25-75/FVC and FEV3/FVC) than those in the normal FEF25-75/AL− group. FEF25-75 decreased with AL severity. A logistic regression model demonstrated that in the absence of AL, the presence of low FEF25-75 was associated with lower FEV1 and FEV1/FVC even when smoking history was accounted for. Low FEF25-75 is a physiological trait in patients with conventional spirometric AL and likely reflects early evidence of impairment in the small airways when spirometry is within the ‘normal range’. FEF25-75 likely identifies a group of patients with early evidence of pathological lung damage who warrant careful monitoring and reinforced early intervention to abrogate further lung injury.
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影响因子：
158.5
作者：
HOGG, JC;MACKLEM, PT;THURLBECK, WM
通讯作者：
THURLBECK, WM
DOI：
10.2147/copd.s221684
发表时间：
2019-01-01
影响因子：
2.8
作者：
Li, Kun;Gao, Yanli;Jiang, Tao
通讯作者：
Jiang, Tao
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
76.2
作者：
Koo, Hyun-Kyoung;Vasilescu, Dragos M.;Hackett, Tillie-Louise
通讯作者：
Hackett, Tillie-Louise
影响因子：
105.7
作者：
FLETCHER, C;PETO, R
通讯作者：
PETO, R