Spirometric criteria for asthma: Adding further evidence to the debate
Spirometric criteria for asthma: Adding further evidence to the debate
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DOI：
10.1016/j.jaci.2005.08.034
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发表时间：
2005-11-01
影响因子：
14.2
通讯作者：
Ruffin, RE
中科院分区：
文献类型：
--
作者：
Appleton, SL;Adams, RJ;Ruffin, RE
背景：肺功能的客观评估被认为对于哮喘的诊断至关重要。被认为支持哮喘的 FEV1 可逆性程度因国际哮喘指南而异。 目的：我们试图比较国际指南可逆性标准的相对表现，用于识别有显着支气管扩张剂反应 (SBR) 但未诊断为哮喘的患者的损伤。方法：西北阿德莱德健康（队列）研究是一项针对 4060 名受试者的人口生物医学研究，根据美国胸科学会标准进行肺活量测定。 SBR 被定义为支气管扩张剂后 FEV1 反应至少为基线值的 12% 或 15%、预测值的 9% 或 400 mL。自行填写的问卷评估了当前哮喘 (CA)、呼吸道症状和参与者人口统计数据。结果：CA 的患病率为 9.4% (n = 380)，而 1.3% (>= 400 mL) 至 4.5%（>= 预测值的 9%）的参与者在没有 CA 的情况下表现出 SBR。除 9% 预测标准外，显示 SBR 但无 CA 组的支气管扩张剂前平均 FEV1（预测百分比）明显低于 CA 组。 SBR 组比没有哮喘的组出现明显更多的呼吸道症状。 Logistic 回归分析确定了按以下标准分类的人的不同特征：12% 和 15%，年龄为 40 岁或以上，家庭收入低于 40,000 美元； 9%的人预测，家庭收入低于4万美元； 400 mL，男性（比值比，4.5；95% CL 2.1-9.3）。结论：不同的标准识别不同的人，但任何标准的 SBR 都与显着的呼吸障碍相关，其中一些可能归因于哮喘。支气管扩张后变化占预测值的百分比是偏差最小的标准。
Background: Objective assessments of pulmonary function are considered essential for the diagnosis of asthma. The degree of reversibility of FEV1 considered supportive of asthma varies between international asthma guidelines.Objective: We sought to compare the relative performance of international guideline reversibility criteria for identifying impairment in persons with a significant bronchodilator response (SBR) without an asthma diagnosis.Methods: The North West Adelaide Health (Cohort) Study, a population biomedical study of 4060 subjects, conducted spirometry according to American Thoracic Society criteria. SBR was defined as postbronchodilator FEV1 responses of at least 12% or 15% of baseline values, 9% of predicted values, or 400 mL. A self-completed questionnaire assessed current asthma (CA), respiratory symptoms, and participant demographics.Results: The prevalence of CA was 9.4% (n = 380), whereas 1.3% (>= 400 mL) to 4.5% (>= 9% of predicted value) of participants demonstrated an SBR in the absence of CA. With the exception of the 9% predicted criterion, prebronchodilator mean FEV1 (percent predicted) in those demonstrating an SBR but no CA was significantly worse than that in the CA group. Significantly more respiratory symptoms were experienced by the SBR groups than the group without asthma. Logistic regression analyses identified different characteristics of those classified by the following criteria: 12% and 15 %, age of 40 years or greater and household income of less than $40,000; 9% predicted, household income of less than $40,000; 400 mL, male sex (odds ratio, 4.5; 95% CL 2.1-9.3).Conclusions: Different criteria identify different persons, but SBR by any criteria was associated with significant respiratory impairment, some of which might be attributable to asthma. Postbronchodilator change as a percentage of predicted value was the least biased of the criteria.