SPIROMETRY IN THE LUNG HEALTH STUDY .2. DETERMINANTS OF SHORT-TERM INTRAINDIVIDUAL VARIABILITY
SPIROMETRY IN THE LUNG HEALTH STUDY .2. DETERMINANTS OF SHORT-TERM INTRAINDIVIDUAL VARIABILITY
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DOI：
10.1164/ajrccm.151.2.7842199
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发表时间：
1995-02-01
影响因子：
24.7
通讯作者：
LEE, WW
中科院分区：
文献类型：
--
作者：
ENRIGHT, PL;CONNETT, JE;LEE, WW
肺健康研究（LHS）是一项随机临床试验，旨在确定吸烟干预计划和使用吸入性支气管扩张剂（ED）是否可以降低气流受限吸烟者FEV下降的速度(1)。在招募期间，在第二次和第三次筛查时进行肺活量测定，平均间隔21 d。共有5,887名吸烟者，年龄在35至60岁之间，其中63%为男性，符合研究资格要求。排除了服用医生处方BDs或FEV(1) < 50%或预测FEV(1)/FVC比值大于70%的吸烟者。两次吸入异丙肾上腺素，以确定第二次就诊时ED的反应。在第三次就诊时进行一系列稀释甲胆碱激发试验以确定非特异性气道反应性。在两次访问中测量的FEV(1)差异中，95%的女性在240毫升内，男性在320毫升内（可重复性系数）。个体内平均短期（两次访问之间）FEV(1)可变性的最佳独立预测因子是指示参与者固有气道反应性的因素：支气管扩张剂反应、甲胆碱反应和喘息的存在；以及受肺活量测定质量影响的因素：基线肺活量测定时最高和第二高FEV(1)s与峰值流量之间的差异，以及达到峰值流量的时间（PEFT）。
The Lung Health Study (LHS) is a randomized clinical trial designed to determine whether a smoking intervention program and use of an inhaled bronchodilator (ED) can reduce the rate of decline of FEV(1) in cigarette smokers with airflow limitation. During recruitment, spirometry was performed at second and third screening visits, a mean of 21 d apart. A total of 5,887 smokers, 35 to 60 yr of age and of whom 63% were men, met the study eligibility requirements. Smokers taking physician-prescribed BDs or with an FEV(1) < 50% or > 90% predicted were excluded, as were those whose FEV(1)/FVC ratio was greater than 70%. Two inhalations of isoproterenol were given to determine ED response during the second visit. A serial dilution methacholine challenge test was done during the third visit to determine nonspecific airway reactivity. Ninety-five percent of the differences between FEV(1) measured at the two visits were within 240 ml for women and within 320 ml for men (coefficients of repeatability). The best independent predictors of the mean shortterm (between visit) intraindividual FEV(1) variability were factors indicating intrinsic airway reactivity of the participants: bronchodilator response, methacholine reactivity, and the presence of wheezing; as well as factors influenced by the quality of spirometry testing: the difference between the highest and second highest FEV(1)s and peak flows during baseline spirometry, and the time to reach peak flow (PEFT).