Transfer factor, lung volumes, resistance and ventilation distribution in healthy adults
Transfer factor, lung volumes, resistance and ventilation distribution in healthy adults
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DOI：
10.1183/13993003.00695-2015
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发表时间：
2016-01-01
影响因子：
24.3
通讯作者：
Vincken, Walter
中科院分区：
文献类型：
--
作者：
Verbanck, Sylvia;Van Muylem, Alain;Vincken, Walter
慢性肺病的监测需要肺功能指标的参考值，包括小气道功能的推定标志物，涵盖广泛的年龄范围。我们测量了健康人群的肺活量、肺一氧化碳传递因子（TLCO）、静态肺容量、阻力和通气分布，研究了20至80岁之间的至少20名性别和每十年的受试者。根据全球肺功能倡议（Global Lung Function Initiative）的参考数据，我们的受试者在1秒内用力呼气量（FEV1）、用力肺活量（FVC）和FEV1/FVC的平均z分数分别为-0.12、0.04和-0.32。得到了可以解释指数变异对年龄和身高的潜在依赖性的参考方程。这项研究针对（但不限于）与哮喘和慢性阻塞性肺疾病研究相关的指标：6秒内强制呼气容积、强制呼气流量、TLCO、特定气道导通、残气量(RV)/总肺活量（TLC），以及肺腺泡区和导肺区通气异质性。腺泡通气异质性和肺清除率指数随年龄的恶化在60岁以上更为明显，传导通气异质性随年龄的变异性增加最大。与公布的参考值最具临床相关性的偏差是RV/TLC值，其显著小于美国胸科协会/欧洲呼吸学会认可的参考值。
Monitoring of chronic lung disease requires reference values of lung function indices, including putative markers of small airway function, spanning a wide age range.We measured spirometry, transfer factor of the lung for carbon monoxide (TLCO), static lung volume, resistance and ventilation distribution in a healthy population, studying at least 20 subjects per sex and per decade between the ages of 20 and 80 years.With respect to the Global Lung Function Initiative reference data, our subjects had average z-scores for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC of -0.12, 0.04 and -0.32, respectively. Reference equations were obtained which could account for a potential dependence of index variability on age and height. This was done for (but not limited to) indices that are pertinent to asthma and chronic obstructive pulmonary disease studies: forced expired volume in 6 s, forced expiratory flow, TLCO, specific airway conductance, residual volume (RV)/total lung capacity (TLC), and ventilation heterogeneity in acinar and conductive lung zones.Deterioration in acinar ventilation heterogeneity and lung clearance index with age were more marked beyond 60 years, and conductive ventilation heterogeneity showed the greatest increase in variability with age. The most clinically relevant deviation from published reference values concerned RV/TLC values, which were considerably smaller than American Thoracic Society/European Respiratory Society-endorsed reference values.