心肺移植和双肺移植中闭塞性细支气管炎的生理学定义：用力肺活量25%至75%之间的用力呼气流量与一秒用力呼气量的比较。

Physiologic definitions of obliterative bronchiolitis in heart-lung and double lung transplantation: a comparison of the forced expiratory flow between 25% and 75% of the forced vital capacity and forced expiratory volume in one second.

作者信息

Patterson G M, Wilson S, Whang J L, Harvey J, Agacki K, Patel H, Theodore J

机构信息

Department of Medicine, Morehouse School of Medicine, Atlanta, Ga., USA.

出版信息

J Heart Lung Transplant. 1996 Feb;15(2):175-81.

PMID:8672521

Abstract

BACKGROUND AND METHODS

A comparison of the forced expiratory flow between 25% and 75% of the forced vital capacity (FEF25-75) and forced expiratory volume in 1 second (FEV1) was conducted for the detection of obstructive airway disease as an early manifestation of obliterative bronchiolitis. Pulmonary function tests performed on heart-lung and double lung transplant recipients between March 1981 and March 1983 were reviewed. Thirty patients were identified who showed progressive deterioration in pulmonary function after transplantation. Ratios determining proportionate decreases were calculated from measurements of absolute values for the FEF25-75 and FEV1 at the point when the FEF25-75 reached < 70% and < or = 30% of predicted, divided by baseline values obtained before the decline in function. Similar ratios were obtained for FEV1 and FEF25-75 at the point the FEV1 declined > or = 20% from its baseline value.

RESULTS

Comparison of the ratios for the FEF25-75 and FEV1 at FEF25-75 values < 70% and < or = 30% of predicted and a similar comparison when the FEV1 declined > or = 20% from baseline showed a greater proportional decrease in FEF25-75 than FEV1 (p < 0.01). With the use of the FEF25-75, declines in airway function were detected earlier. After transplantation a decline in FEF25-75 to < 70% of predicted occurred approximately 112 days before a 20% decline a FEV1.

CONCLUSION

The FEF25-75 is more sensitive than the FEV1 for the early detection of obliterative bronchiolitis. A presumptive diagnosis of obliterative bronchiolitis can be made with physiologic criteria, providing infection or acute rejection has been ruled out. When conducting epidemiologic studies or for vital statistics we propose that a decline in FEF25-75 to < 70% be used to define the onset of obliterative bronchiolitis.

摘要

背景与方法

对用力肺活量的25%至75%之间的用力呼气流量（FEF25 - 75）和1秒用力呼气量（FEV1）进行比较，以检测作为闭塞性细支气管炎早期表现的阻塞性气道疾病。回顾了1981年3月至1983年3月期间对心肺移植和双肺移植受者进行的肺功能测试。确定了30例移植后肺功能逐渐恶化的患者。从FEF25 - 75达到预测值的<70%和<或 = 30%时FEF25 - 75和FEV1绝对值的测量值计算出确定成比例下降的比率，并除以功能下降前获得的基线值。在FEV1从其基线值下降>或 = 20%时，对FEV1和FEF25 - 75也获得了类似的比率。

结果

当FEF25 - 75值<预测值的70%和<或 = 30%时，对FEF25 - 75和FEV1的比率进行比较，以及当FEV1从基线值下降>或 = 20%时进行类似比较，结果显示FEF25 - 75的成比例下降大于FEV1（p < 0.01）。使用FEF25 - 75时，气道功能下降能被更早检测到。移植后，FEF25 - 75下降至预测值的<70%大约比FEV1下降20%早112天。