Determinants of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC in chronic spinal cord injury
Determinants of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC in chronic spinal cord injury
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DOI：
10.1016/j.apmr.2006.06.015
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发表时间：
2006-10-01
影响因子：
4.3
通讯作者：
Garshick, Eric
中科院分区：
文献类型：
--
作者：
Jain, Nitin B.;Brown, Robert;Garshick, Eric
目的：评估影响肺功能的因素，因为呼吸系统功能障碍在慢性脊髓损伤（SCI）中很常见。设计：横断面队列研究。设置：退伍军人事务部波士顿SCI服务和社区。参与者：在1994年和2003年之间，339名患有慢性SCI的白色男性完成了呼吸问卷并进行了肺功能测定。干预措施：不适用。主要结果测量：1秒用力呼气量（FEV 1）、用力肺活量（FVC）和FEV 1/FVC。（-21.0 mL/y; 95%置信区间[CI]，-26.3至-15.7 mL/y）和FVC（-17.2 mL/y; 95% CI，-23.7至-10.8 mL/y）随年龄增长而下降。终生吸烟也与FEV 1降低相关（-3.8 mL/包-年; 95% CI，-6.5至-1.1 mL/包-年），持续喘息和体重指数升高与FEV 1/FVC降低相关。最大吸气压（MIP）越大，FEV 1和FVC越大。FEV 1随伤后时间延长而显著降低（-6。1 mL/y; 95% CI，-11.7至-0.6mL/y），在神经功能受损最严重的患者中降幅最大。神经功能受损最严重的人的FEV 1/ FVC也更大，并且他们的FEV 1和FVC受年龄和吸烟的影响较小。结论：除了SCI水平和完整性之外，吸烟、持续性喘息、肥胖和MIP是肺功能的重要决定因素。在SCI中，FEV 1、FVC和FEV 1/FVC可能对与气道大小变化相关的因素不太敏感，并且不能可靠地检测气流阻塞的严重程度。
Objective: To assess factors that influence pulmonary function, because respiratory system dysfunction is common in chronic spinal cord injury (SCI).Design: Cross-sectional cohort study.Setting: Veterans Affairs Boston SCI service and the community.Participants: Between 1994 and 2003, 339 white men with chronic SCI completed a respiratory questionnaire and underwent spirometry.Interventions: Not applicable.Main Outcome Measures: Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC.Results: Adjusting for SCI level and completeness, FEV1 (-21.0mL/y; 95% confidence interval [CI], -26.3 to -15.7 mL/y) and FVC (-17.2mL/y; 95% CI, -23.7 to -10.8mL/y) declined with age. Lifetime cigarette use was also associated with a decrease in FEV1 (-3.8mL/pack-year; 95% CI, -6.5 to -1.1 mL/pack-year), and persistent wheeze and elevated body mass index were associated with a lower FEV1/FVC. A greater maximal inspiratory pressure (MIP) was associated with a greater FEV1 and FVC. FEV1 significantly decreased with injury duration (-6. 1mL/y; 95% CI, -11.7 to -0.6mL/y), with the greatest decrement in the most neurologically impaired. The most neurologically impaired also had a greater FEV1/ FVC, and their FEV1 and FVC were less affected by age and smoking.Conclusions: Smoking, persistent wheeze, obesity, and MIP, in addition to SCI level and completeness, were significant determinants of pulmonary function. In SCI, FEV1, FVC, and FEV1/FVC may be less sensitive to factors associated with change in airway size and not reliably detect the severity of airflow obstruction.