哮喘联盟

    目的：慢性阻性肺疾病（COPD）是一种诊断不足的疾病。本研究的目的是评估微型肺量计在检测吸烟者（即慢性阻性肺疾病（COPD）高危人群）下降的FEV1值中的作用。
    方法：研究纳入正在吸烟或以前吸烟、吸烟史大于20年并且之前未确诊患有肺疾病的611名研究对象，其中男性389人，年龄27～83岁，平均年龄56岁，平均吸烟史为35包年，19%为以前吸烟者。
    结果：微型肺量测计测定发现44.6%的研究对象FEV1 占预计值百分比< 80%，FEV1平均为2.8 L（占预计值百分比为80.6%，范围26%～121%）。这与完全肺量测定法的测定值极为相关（R=0.965, p<0.0001）。详细的调查表回答表明近一半的研究对象（48.2%）有慢性咳嗽和咳痰，39.8%的研究对象在运动时呼吸困难。
    结论：微型肺量测计发现许多正在吸烟者和以前吸烟者的FEV1值下降。微型肺量测计检测迅速。停止吸烟对微型肺量测计发现FEV1值下降的所有吸烟者的健康有益，所有FEV1值下降的患者都要考虑进行完全肺量测定法，以证实是否患有慢性阻性肺疾病（COPD）。

（刘国梁审校）
Rytila P, et al. Prim Care Respir J. 2008 Dec; 17(4):232-237.  Links

The use of microspirometry in detecting lowered FEV1 values in current or former cigarette smokers.

AIMS: COPD is an underdiagnosed disease. This study was undertaken to assess the value of microspirometry in detecting reduced FEV1 values in cigarette smokers, i.e., subjects at high risk for COPD.
METHODS: A total of 611 smokers or ex-smokers with a smoking history >20 years and no previously-diagnosed lung disease were recruited (389 male, age 27-83 years, mean age 56 years, mean smoking history 35 pack years, 19% ex-smokers).
RESULTS: An FEV1 < 80% predicted on microspirometry was found in 44.6% of cases. The mean FEV1 was 2.8 litres (80.6% predicted, range 26-121%). This correlated well with values obtained from full spirometry (R=0.965, p<0.0001). Detailed questionnaire responses revealed that almost half of the subjects (48.2%) reported chronic cough and sputum production and 39.8% reported breathlessness during exercise.
CONCLUSIONS: Microspirometry finds a considerable number of smokers or ex-smokers with reduced FEV1 values. Microspirometry is quick to perform. All smokers with reduced microspirometry FEV1 values would benefit from smoking cessation, and all patients with reduced FEV1 values need to be considered for full spirometry to confirm if they actually have COPD.