慢阻肺中第一秒与六秒用力呼气容积比值应用研究

The study on forced expiratory volume in one second （ FEV1 ） forced expiratory volume in six seconds （FEV6 ） in patients with chronic obstructive pulmonary disease

目的探讨第1秒用力呼气容积与6秒用力呼气容积比值（FEV1／FEV6）在慢性阻塞性肺疾病（COPD）诊断方面的临床价值。方法对120例COPD稳定期患者和80例健康者进行肺量测定，前者依据中华医学会制定的《慢性阻塞性肺疾病诊治指南（2007年修订版）》进行分级，分为COPDI-Ⅱ级组、Ⅲ-Ⅳ级组。结果COPDI-Ⅱ级组FEV1／pre、FEV1／FVC、FEV1／FEV6较对照组明显降低，而COPI）Ⅲ-Ⅳ级组与对照组相比，FVC／pre、FEV6／pre、FEV1／pre、FEV1／FVC、FEV1／FEV1显著降低。COPDI-Ⅱ级组FEV1／pre、FVC／pre下降幅度比FEV1／FVC、FEV1／FEV6低；在COPDⅢ-Ⅳ级组FEV，／pre、FVC／pre的下降幅度比FEV。／FVC、FEV，／FEV。的下降幅度要高。COPDⅢ-Ⅳ级组的CV[FVC]高于COPDI-Ⅱ级组和对照组。FEV1／FEV6和FEV1／FVC呈显著正相关。结论相比FVC，FEV6有着更好的重复性，而FEV1／FEV6和FEV1／FVC也有着显著的相关性，同样可以准确反映气流受限，且测试更为简单。

Objective To investigate the diagnostic value of FEV1/FEV6 in chronic obstructive pulmonary disease （COPD）. Methods 120 stable COPD patients and 80 healthy controls were performed spirometry. The former was staged following the guideline for diagnosis and management of COPD made by Chinese Medical Association. Result Compared with control group,COPD Ⅰ -Ⅱ group showed a significant decrease in FEV1/pre and FEV1/FVC and FEV1/FEV6 ,and COPD Ⅲ-Ⅳ group showed a significant decrease in FVC/pre and FEV6/pre and FEV1pre and FEV1/FVC and FEV1/FEV6 ;the difference was significant （P 〈 0.05 ）. On the other hand, the descensus of FEV1/pre and FVC/pre was less than FEV1/ FVC and FEV1/FEV6 in COPD Ⅰ - Ⅱ group,and the descensus of FEV1/pre and FVC/pre was more than FEV1/FVC and FEV1/FEV6 in COPD Ⅲ-Ⅳ group. CV [ FVC] in COPD Ⅲ-Ⅳ group was bigger than those in COPD Ⅰ- Ⅱgzoup and control group. In Pearson correlation analysis, FEV1/FEV6 and FEV1/FVC were positively correlated significantly. Conclusion Compared with FVC, FEV6 has a better reproducibility and can be performed easily. FEV1/FEV6 has a significant correlation with FEV1/FVC ,and can reflect airflow limitation accurately. Thus,it can be used in COPD diagnosis and staging.