診斷的GOLD標(biāo)準(zhǔn)采用吸入支氣管舒張劑后一秒率(FEV1/FVC) lt;70%來(lái)進(jìn)行定性診斷。該標(biāo)準(zhǔn)簡(jiǎn)單、方便,在國(guó)際及國(guó)內(nèi)被廣泛采用。隨著GOLD標(biāo)準(zhǔn)的進(jìn)一步推廣和對(duì)傳統(tǒng)肺功能重視程度的下降,也出現(xiàn)了一些有爭(zhēng)議的問(wèn)題。一、COPD是否就是阻塞性通氣障礙?二、FEV1/FVC lt;70%是否就是COPD和阻塞性通氣障礙的共同標(biāo)準(zhǔn)?三、COPD的分級(jí)標(biāo)準(zhǔn)是否是阻塞性通氣障礙的分級(jí)標(biāo)準(zhǔn)?四、COPD和其他氣道阻塞性疾病是否一定出現(xiàn)一秒率的下降?五、氣道舒張?jiān)囼?yàn)后的一秒率對(duì)診斷COPD是否合理?六、COPD診斷指標(biāo)與療效評(píng)價(jià)指標(biāo)為什么不一致?七、如何評(píng)價(jià)肺功能對(duì)鑒別診斷的價(jià)值?
引用本文: 朱蕾,馮玉麟. 客觀評(píng)價(jià)慢性阻塞性肺疾病的肺功能診斷標(biāo)準(zhǔn). 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 09(4): 315-317. doi: 復(fù)制
1. | Rabe KF, Hurd S, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit care Med, 2007, 176: 532-555. |
2. | 中華醫(yī)學(xué)會(huì)呼吸病學(xué)分會(huì)慢性阻塞性肺疾病學(xué)組. 慢性阻塞性肺疾病診治指南( 2007 年修訂版) . 中華結(jié)核和呼吸雜志,2007, 30: 8-17. |
3. | 周營(yíng)營(yíng), 朱蕾. 慢性阻塞性肺疾病的肺功能診斷標(biāo)準(zhǔn)不等同于阻塞性通氣功能障礙的診斷標(biāo)準(zhǔn). 中國(guó)呼吸與危重監(jiān)護(hù)雜志,2008, 7: 323-324. |
4. | 朱蕾, 周營(yíng)營(yíng). 回復(fù)《對(duì)阻塞性通氣功能障礙嚴(yán)重程度與慢性阻塞性肺疾病嚴(yán)重程度標(biāo)準(zhǔn)的疑惑》. 中華結(jié)核和呼吸雜志,2009, 32: 319-320. |
5. | Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J, 2005, 26: 948-968. |
6. | 朱蕾, 劉又寧, 于潤(rùn)江, 主編. 臨床肺功能. 北京: 人民衛(wèi)生出版社, 2004. |
7. | th ed. Chicago: AMA Press, 2000, 8. |
8. | 朱蕾, 劉又寧, 鈕善福, 主編. 臨床呼吸生理學(xué). 北京: 人民衛(wèi)生出版社, 2008. |
9. | Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J, 2005, 26: 948-968. |
10. | Cocchiarella L, Anderson GB. Guides to the evaluation of permanent impairment. |
11. | Menezes AM, Perez-Padilla R, JardimJR, et al. Chronic obstructive pulmonary disease in five Latin American cities ( the PLATINO study) : a prevalence study. Lancet, 2005, 26: 1875-1881. |
12. | Falaschetti E, Laiho J, Primatesta P, et al. Prediction equations for normal and low lung function from the Health Survey for England. Eur Respir J, 2004, 23: 456-463. |
13. | 周營(yíng)營(yíng), 劉莉, 胡莉娟, 等. 采用一秒率的不同標(biāo)準(zhǔn)作為定性指標(biāo)對(duì)慢性阻塞性肺疾病患病率的影響. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 8: 16-18. |
14. | Roberts SD, Farber MO, Knox KS, et al. FEV1 /FVC ratio of 70% misclassifies patients with obstruction at the extremes of age. Chest,2006, 130: 200-206. |
15. | Pérez-Padilla R, Hallal PC, Vázquez-García JC, et al. Impact of bronchodilator use on the prevalence of COPD in population-based samples. COPD, 2007, 4: 113-120. |
16. | 殷凱生, 孫培莉, 姚欣, 等. 回復(fù)《如何判斷支氣管舒張?jiān)囼?yàn)陰性時(shí)對(duì)診斷支氣管哮喘的意義》. 中華結(jié)核和呼吸雜志, 2005,28: 852. |
- 1. Rabe KF, Hurd S, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit care Med, 2007, 176: 532-555.
- 2. 中華醫(yī)學(xué)會(huì)呼吸病學(xué)分會(huì)慢性阻塞性肺疾病學(xué)組. 慢性阻塞性肺疾病診治指南( 2007 年修訂版) . 中華結(jié)核和呼吸雜志,2007, 30: 8-17.
- 3. 周營(yíng)營(yíng), 朱蕾. 慢性阻塞性肺疾病的肺功能診斷標(biāo)準(zhǔn)不等同于阻塞性通氣功能障礙的診斷標(biāo)準(zhǔn). 中國(guó)呼吸與危重監(jiān)護(hù)雜志,2008, 7: 323-324.
- 4. 朱蕾, 周營(yíng)營(yíng). 回復(fù)《對(duì)阻塞性通氣功能障礙嚴(yán)重程度與慢性阻塞性肺疾病嚴(yán)重程度標(biāo)準(zhǔn)的疑惑》. 中華結(jié)核和呼吸雜志,2009, 32: 319-320.
- 5. Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J, 2005, 26: 948-968.
- 6. 朱蕾, 劉又寧, 于潤(rùn)江, 主編. 臨床肺功能. 北京: 人民衛(wèi)生出版社, 2004.
- 7. th ed. Chicago: AMA Press, 2000, 8.
- 8. 朱蕾, 劉又寧, 鈕善福, 主編. 臨床呼吸生理學(xué). 北京: 人民衛(wèi)生出版社, 2008.
- 9. Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J, 2005, 26: 948-968.
- 10. Cocchiarella L, Anderson GB. Guides to the evaluation of permanent impairment.
- 11. Menezes AM, Perez-Padilla R, JardimJR, et al. Chronic obstructive pulmonary disease in five Latin American cities ( the PLATINO study) : a prevalence study. Lancet, 2005, 26: 1875-1881.
- 12. Falaschetti E, Laiho J, Primatesta P, et al. Prediction equations for normal and low lung function from the Health Survey for England. Eur Respir J, 2004, 23: 456-463.
- 13. 周營(yíng)營(yíng), 劉莉, 胡莉娟, 等. 采用一秒率的不同標(biāo)準(zhǔn)作為定性指標(biāo)對(duì)慢性阻塞性肺疾病患病率的影響. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 8: 16-18.
- 14. Roberts SD, Farber MO, Knox KS, et al. FEV1 /FVC ratio of 70% misclassifies patients with obstruction at the extremes of age. Chest,2006, 130: 200-206.
- 15. Pérez-Padilla R, Hallal PC, Vázquez-García JC, et al. Impact of bronchodilator use on the prevalence of COPD in population-based samples. COPD, 2007, 4: 113-120.
- 16. 殷凱生, 孫培莉, 姚欣, 等. 回復(fù)《如何判斷支氣管舒張?jiān)囼?yàn)陰性時(shí)對(duì)診斷支氣管哮喘的意義》. 中華結(jié)核和呼吸雜志, 2005,28: 852.