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Field and laboratory evaluation of a refined method for assessing small airway function.

机译：现场和实验室评估，用于评估小气道功能的完善方法。

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摘要

Background. The small airways are often the target for air pollutants such as ozone and particulate matter and have been shown to be the initial site of injury leading to chronic airway obstruction. Spirometric measures commonly used to assess airway effects are not specific to the small airways and measures that encompass the small airway region of the lung are highly variable and, therefore, not sensitive for detecting subtle changes associated with exposure to ambient air pollution.; Objective. The objective of this study was to test a statistically refined small airway measure in the laboratory and in the field to assess its variability and sensitivity under controlled and real-world conditions.; Methods. To create the refined small airway measure, points along the flow-volume curve encompassing the small airway region of the lung (between 50 and 75% of forced vital capacity) were smoothed using a locally weighted regression and then averaged to give one flow point representative of that airway region (FEF50↔75). In the laboratory, the forced vital capacity maneuver was administered to 20 healthy, non-smoking adult volunteers (ages 25 to 40) on three separate occasions separated by no more than two weeks. The variability and sensitivity of the FEF50↔75 metric was then compared to traditional measures of small airway function. The sensitivity of the FEF50↔75 was then evaluated in the field using elite cyclists who exercise vigorously outdoors. The cyclists' exposure to ozone and particulate matter was measured along with the estimated inhaled dose of ozone.; Results. In the laboratory, the FEF50 measure provided the most sensitive measure of small airway function. It was followed in rank by FEF25-75, FEF50↔75, FEF50-75 and FEF75. In the field, airway decrements (in FVC, FEV1 and FEF50 adjusted for FVC) were associated with ozone exposure (p0.0001) at levels below the current EPA standard of 80 ppb, in spite of improvements in airway function that can be attributed to the effect of exercise.; Conclusions. Although the FEF50↔75 measure did not offer significant improvements over traditional measures, it was slightly less variable than traditional methods that encompass the same segment of the flow-volume curve. Furthermore, decreases in pulmonary function were documented in healthy, highly-trained athletes at levels below current standards.
机译：背景。小型气道通常是诸如臭氧和颗粒物等空气污染物的目标，并且已被证明是导致慢性气道阻塞的最初伤害部位。通常用于评估气道影响的肺活量测量方法并不特定于小气道，而涵盖肺小气道区域的测量值变化很大，因此对于检测与暴露于环境空气污染相关的细微变化并不敏感。目的。这项研究的目的是在实验室和现场测试经过统计精炼的小气道测量，以评估其在受控和现实条件下的可变性和敏感性。方法。为了创建精炼的小气道测量值，使用局部加权回归平滑沿围绕肺小气道区域（在强制肺活量的50％至75％之间）的流量曲线的点，然后取平均值以得到一个代表性的流点（FEF50↔75）。在实验室中，在不超过两周的三个不同情况下，分别对20名健康的非吸烟成年志愿者（25至40岁）进行了强制肺活量调节。然后，将FEF50↔75指标的可变性和敏感性与传统的小气道功能指标进行比较。然后，由在户外大力运动的精英骑自行车者在野外评估FEF50↔75的灵敏度。测量骑自行车者暴露于臭氧和颗粒物的时间以及估计的臭氧吸入剂量。结果。在实验室中，FEF50量度提供了对小气道功能最敏感的量度。紧随其后的是FEF25-75，FEF507575，FEF50-75和FEF75。在野外，尽管气道功能有所改善，但气道功能的改善（由于FVC，FEV1和FEF50调整为FVC）与臭氧暴露（p <0.0001）的水平低于当前EPA标准80 ppb有关。运动的效果。结论。尽管FEF50↔75度量值没有比传统度量值有显着改善，但与包含相同流量曲线段的传统方法相比，它的可变性稍差。此外，在健康，训练有素的运动员中，肺功能下降的水平低于当前标准。

著录项

  • 作者

    LaRosa, Laura Escandell.;

  • 作者单位

    The Johns Hopkins University.;

  • 授予单位 The Johns Hopkins University.;
  • 学科 Environmental Sciences.
  • 学位 Ph.D.
  • 年度 2006
  • 页码 90 p.
  • 总页数 90
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 环境科学基础理论;
  • 关键词

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