慢阻肺支气管舒张试验后FEV1与FVC改变值和改变率的比较

Comparative study on the changes of value and rate of FEV1 and FVC after the bronchial dilation test in COPD patients

关键词:  用力肺活量  第1秒用力呼气容积  慢性阻塞性肺疾病  支气管舒张试验

Key words:  FVC  FEV1  COPD  Bronchial dilation test

摘要:

目的　研究慢性阻塞性肺疾病（COPD）患者支气管舒张试验后FEV₁与FVC改变值和改变率及改善率的比较，以更准确地评估其对COPD的临床意义。方法　选择248例COPD患者，均行肺功能和支气管舒张试验，观察支气管舒张试验前后FEV₁和FVC的变化，对支气管舒张后FEV₁和FVC的改变值和改变率进行比较。结果　支气管舒张试验后，COPD患者的FEV₁改变值平均增加133.9 mL，较基础值提高（改变率）6.93%，改善率为52.2%；FVC改变值平均增加336.7 mL，较基础值提高（改变率）11.36%，改善率为73.1%。FEV₁与FVC的改变值和改变率差异均有统计学意义(P均<0.01)。结论　COPD患者吸入支气管舒张剂后FEV₁和FVC均有所增加，但FVC的改善较FEV₁更为显著，FVC的变化较FEV₁敏感，提示FVC应作为诊断COPD的重要指标。

Abstract:

Objective To evaluate the clinical value of bronchial dilation test in COPD patients, and to compare the changes of value and improvement rate of FEV₁ and FVC after the bronchial dilation test. Methods Totally, 248 patients who were diagnosed with COPD were selected. The patients were evaluated for pulmonary function test and bronchial dilation test. The changes of FEV₁ and FVC before and after bronchodilator relaxation test were compared. The value change, the improvement rate and the rage of positive reversibility of FEV₁ and FVC were analyzed. Results Post-bronchodilator FEV₁ increased 133.9 mL with 6.93% improvement on average compared to the baseline. Post-bronchodilator FVC increased 336.7 mL and improved by 11.36% on average. The rate of improvement in FEV₁ and FVC was 52.2% and 73.1%, respectively. The changes in value and improvement rate of FEV1 and FVC were statistically significant (P<0.01). Conclusion FEV₁ and FVC are increased in patients with COPD, but the improvement of FVC is more significant than that of FEV1. The change of FVC is more sensitive than that of FEV₁, suggesting that FVC could be used as an important index for the diagnosis of COPD.