Short term variability in FEV1 and bronchodilator responsiveness in patients with obstructive ventilatory defects.
Short term variability in FEV1 and bronchodilator responsiveness in patients with obstructive ventilatory defects.
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DOI：
10.1136/thx.42.7.487
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发表时间：
1987-07
期刊：
影响因子：
10
通讯作者：
P. Tweeddale;F. Alexander;G. Mchardy
中科院分区：
文献类型：
--
作者：
P. Tweeddale;F. Alexander;G. Mchardy
本文测定了150例阻塞性肺功能不全患者FEV_1的短期变异性和对吸入性支气管扩张剂的反应性。初始FEV 1的范围为0.5-4.71，以绝对值表示的20分钟内的自然变异性在整个范围内相似，与正常受试者的差异不显著。在95%置信度下，排除自然变异性所需的FEV 1和肺活量（VC）增加分别为160 ml和330 ml。当以百分比表示时，自然变异性与记录的FEV 1水平呈负相关。支气管扩张剂给药后FEV 1和VC变化的分析采用绝对和百分比缓解标准。根据所用标准，应答者的数量差异很大。在根据绝对标准定义为应答者的患者中，没有证据表明应答大小与FEV 1水平相关。传统上使用百分比标准来识别可能有临床意义的支气管扩张剂反应，而绝对标准虽然在统计学上有效，但并不受欢迎。需要重新评估所使用的标准及其局限性和影响。
Short term variability in FEV1 and responsiveness to inhaled bronchodilator were measured in 150 patients with obstructive ventilatory defects. The range of initial FEV1 was 0.5-4.71 and the natural variability over a 20 minute period when expressed in absolute terms was similar over the entire range, and differed insignificantly from that found in normal subjects. The increase in FEV1 and vital capacity (VC) required to exclude natural variability with 95% confidence in these patients was 160 ml and 330 ml respectively. Natural variability when expressed in percentage terms was negatively correlated with the level of FEV1 recorded. The analysis of changes in FEV1 and VC after administration of bronchodilator used absolute and percentage criteria for response. The number of responders differed considerably according to the criterion used. In those defined by the absolute criterion as responders there was no evidence that size of response was related to level of FEV1. Percentage criteria have traditionally been used to identify responses to bronchodilator that may be clinically useful, while absolute criteria, although statistically valid, have not been favoured. Reappraisal of the criteria used and their limitations and implications is required.