Longitudinal changes in forced expiratory volume in one second in adults. Methodologic considerations and findings in healthy nonsmokers.
Longitudinal changes in forced expiratory volume in one second in adults. Methodologic considerations and findings in healthy nonsmokers.
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成人一秒用力呼气量的纵向变化。
DOI：
10.1164/arrd.1986.133.6.974
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Knudson,RJ
中科院分区：
文献类型：
--
作者：
Burrows,B;Lebowitz,MD;Camilli,AE;Knudson,RJ
在亚利桑那州图森市的一般人群样本中检查了FEV1（ΔFEV1）的纵向变化。在11年的时间内进行的所有7次调查中，肺功能测试结果令人满意的成年人在平均FEV1方面显示出一些调查间差异。虽然绝对值很小，但这种调查偏倚（除非对相对较大的受试者组进行多次肺量测定，否则不可能检测到）可能对FEV1的计算变化产生显著影响，并可能解释文献中报告的Δ FEV1值差异很大的原因。在对调查偏差进行调整后，对平均随访9.6年的健康非吸烟人群进行Δ FEV 1与年龄、性别和体型的关系研究。FEV1随年龄增长而加速下降，Δ FEV1最好用比例变化模型解释，其中它是年龄X身高的函数3。纵向测定的Δ FEV 1显示功能下降程度远低于横断面分析，且出现下降的明显年龄较晚。虽然不能排除纵向计算中的小的“学习效应”，但大多数横截面与纵向差异可能归因于对老年人FEV1产生不利影响的过去事件，从而增加了横截面年龄效应。目前的研究结果还表明，一般适用的“预测方程”的Δ FEV 1可能无法开发，Δ FEV 1值应该只比较组间研究中相同的方式在一个给定的研究。横断面分析得出的年龄系数不能预测FEV1的年变化，而且大多数横断面得出的“预测方程”随着时间的推移可能会逐渐低估FEV1，尤其是年轻人。
Longitudinal changes in FEV1(ΔFEV1) have been examined in a sample of the general population of Tucson, Arizona. Adults with satisfactory spirometric tests in all 7 surveys performed over a period of 11 yr showed some between-survey differences in mean FEV1. Although small in absolute magnitude, such survey biases (which would be impossible to detect unless multiple spirometric tests were carried out on a relatively large group of subjects) could have a marked effect on calculated changes in FEV1and may explain the widely divergent ΔFEV1values reported in the literature. After adjusting for survey biases, the relationships of ΔFEV1to age, sex, and body size were examined in “healthy” nonsmokers in the population who were followed for an average of 9.6 yr. The FEV1showed an accelerating decline with age, and ΔFEV1was best explained by a model of proportional change in which it is a function of Age X Height3. Longitudinally determined ΔFEV1showed much less decline in function and a later apparent age of onset of decline than suggested by cross-sectional analyses. While small “learning effects” in longitudinal calculations cannot be excluded, most of the cross-sectional versus longitudinal differences are probably ascribable to past events that have adversely affected the FEV1in older adults, thereby increasing cross-sectional age effects. Present findings also suggest that generally applicable “prediction equations” for ΔFEV1probably cannot be developed and that ΔFEV1values should only be compared between groups studied in an identical manner within a given study. The age coefficients derived from cross-sectional analyses do not predict the observed annual change in FEV1, and most cross-sectionally derived “prediction equations” are likely to progressively underestimate FEV1as time elapses, especially for young adults.