FEV_1%和FEV_1/FVC对判断高原地区慢性阻塞性肺疾病气流阻塞的比较研究

The comparison of FEV_1% with FEV_1/FVC as a diagnostic criteria of airflow obstruction in chronic obstructive pulmonary disease at altitudes

目的 :比较FEV1占预计值百分比 (FEV1% )与FEV1/FVC比值 (FEV1/FVC)对判断高原COPD气流阻塞的应用价值。方法 :对比分析了海拔 2 2 6 0～ 390 0m地区 86例COPD、32例限制性通气功能障碍患者和 30例健康人的FEV1%与FEV1/FVC。结果 :COPD组FEV1%与FEV1/FVC呈正相关 (r=0 .897,P <0 .0 1)。依FEV1% <82 %、FEV1/FVC <77%作为判断气流阻塞标准 ,COPD组分别为 87.2 1%和 86 .0 5 % ,限制组分别为 84.38%和 12 .5 0 % (P <0 .0 1)。作为COPD分级标准 ,FEV1%与FEV1/FVC的下降不一致 ,Ⅱ、Ⅲ级FEV1/FVC显著高于FEV1% (P <0 .0 1或P <0 .0 5 ) ,Ⅰ级略低于FEV1% (P >0 .0 5 )。结论 :FEV1%和FEV1/FVC对诊断高原COPD气流阻塞均有较高的应用价值 ,FEV1/FVC能较好地区别阻塞性与限制性通气功能障碍 ,在判断气流阻塞分级时 ,FEV1%较好。

Objective:To compare the value of the percent of the forced expiratory volume in 1 second expressed to predicted(FEV 1%)with the quotient of the forced expiratory volume in 1 second to the forced vital capacity(FEV 1/FVC)as a diagnostic criteria of airflow obstruction in chronic obstructive pulmonary disease (COPD)at altitudes.Methods:Results of pulmonary function test of 86 cases of COPD,32 cases of restrictive ventilative dysfunction(RVD)and 30 healthy persons at 2 260-3 900 m altitudes were analysed.Results:FEV 1% was significantly positively correlated with FEV 1/FVC( r =0.897, P <0.01)in COPD group.By FEV 1%<82%,FEV 1/FVC<77% as a diagnostic criteria of airflow obstruction,the positive rates were 87.21% and 86.05% in COPD group and 84.38% and 12.50%( P <0.01) in RVD group respectively.FEV 1% was not correlated with FEV 1/FVC as a grading criteria of COPD.The level of FEV 1/FVC was significantly higher than that of FEV 1% in Ⅱand Ⅲ degree and lower in Ⅰdegree COPD.Conclusion:FEV 1% and FEV 1/FVC have important value as diagnostic criterias of airflow obstruction in COPD at altitudes.FEV 1/FVC is better in distinguishing RVD from COPD.FEV 1% is better than FEV 1/FVC as a grading criteria of airflow obstruction.