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首页> 外文期刊>The Internet Journal of Pulmonary Medicine >Difference Between The Slow Vital Capacity And Forced Vital Capacity: Predictor Of Hyperinflation In Patients With Airflow Obstruction
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Difference Between The Slow Vital Capacity And Forced Vital Capacity: Predictor Of Hyperinflation In Patients With Airflow Obstruction

机译：慢肺活量和强迫肺活量之间的差异：气流阻塞患者恶性通气的预测因子

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Introduction: The aim of our study was to assess the relation between the difference in the vital capacity (dVC) measured by means of forced manoeuvres (forced vital capacity - FVC - ) and slow (expiratory vital capacity - EVC -) and the presence of air trapping. We also studied the predictive value of this difference as a marker of the degree of air trapping. Methods: 162 consecutive individuals with suspected airflow obstruction comprised the study cohort. A simple spirometry and a determination of lung volumes by plethysmography were performed in all patients. The patients were classified in not obstructive, mild, moderate and severe obstructive. We randomly divided the 124 obstructive patients in two groups: regression group (n=94) and validation group (n=30). A multiple regression analysis was carried out, in which the hyperinflation (RV/TLC) composed the dependent variable and age, body mass index (BMI), forced expiratory volume in the first second (FEV1), and dVC composed the independent variables in the model. We subsequently verified the equation in the validation group. Results: Thirty-eight patients were non-obstructive, 53 presented with mild obstruction, 39 moderate and 32 severe obstruction. The FVC was a 3,1% lower than the EVC in non-obstructive individuals, a 5,1% lower in those with mild obstruction, 10% lower in the moderate obstructive and a 16,8% lower in the severe obstructive groups. In the regression analysis FEV1 and dVC explained the 52% of the variability of the hyperinflation. Conclusions: The FVC is lower than the EVC either in normal individuals or in obstructive patients. The difference between the FVC and the EVC increases with the degree of obstruction. Hyperinflation in patients with airway obstruction is determined by the degree of obstruction (FEV1) and by the difference in the vital capacity between forced and slow manoeuvres. Introduction The European Respiratory Society (1) establishes three methods to measure the vital capacity (VC): inspiratory vital capacity (IVC), expiratory vital capacity (EVC) and forced vital capacity (FVC). The IVC begins with a slow manoeuvre from residual volume (RV) and ends at the total lung capacity (TLC). The EVC starts with a slow manoeuvre from TLC and concludes in RV. The FVC, contrary to the two previous, consists on a forced manoeuvre that begins in TLC and ends at the RV. In healthy young individuals the difference between the slow and forced vital capacity is practically null (2), while in those with airflow obstruction this could be important. For this reason the European Respiratory Society recommends the use of the slow manoeuvres to measure the vital capacity (1). The RV is determined by the elastic properties of the thoracic wall (3) and by the expiratory air flow limitation (4). In healthy individuals, the RV is mainly determined by this property, but in those patients presenting with airflow limitation the decrease of the expiratory flow would lead to dynamic hyperinflation and RV increase. Currently, volume and flow determinations are routinely based on forced spiromety. It is noted that the difference between the FVC and slow VC is related to the hyperinflation during the forced expiration (2,4), but there is little information in the literature in this regard (5). The aim of our study was to assess the relation between the difference in the vital capacity (dVC) measured by means of slow versus forced manoeuvres and the presence of hyperinflation. We also studied the predictive value of this difference as a marker of the degree of hyperinflation determined by a slow manoeuvre. Methods We studied 162 consecutive individuals referred to one functional examination laboratory with suspected obstructive lung disease (asthma or chronic obstructive pulmonary disease –COPD-). In all patients, besides the spirometry, lung volumes were determined. All values above 80% and 70% of the predicted FEV1 and FEV1/FVC respectively, were considered normal. Pati
机译：简介：我们研究的目的是评估通过强制操作（强制肺活量-FVC-）和缓慢（呼气肺活量-EVC-）测量的肺活量（dVC）差异与存在空气陷阱。我们还研究了这种差异的预测值，作为空气滞留程度的标志。方法：该研究队列包括162名连续的可疑气流阻塞患者。对所有患者进行简单的肺量测定法和通过体积描记法测定肺容量。将患者分为非阻塞性，轻度，中度和严重阻塞性。我们将124例阻塞性患者随机分为两组：回归组（n = 94）和验证组（n = 30）。进行了多元回归分析，其中恶性通货膨胀（RV / TLC）包括因变量，年龄，体重指数（BMI），第一秒钟的强制呼气量（FEV1）和dVC构成了自变量。模型。随后，我们在验证组中验证了该方程。结果：38例患者无阻塞，轻度阻塞53例，中度阻塞39例，重度阻塞32例。在非阻塞性个体中，FVC比EVC低3.1％，在轻度阻塞性个体中，FVC低5.1％，在中度阻塞性疾病中低10％，在严重阻塞性人群中低16.8％。在回归分析中，FEV1和dVC解释了52％的恶性通货膨胀。结论：正常人或阻塞性患者的FVC均低于EVC。 FVC和EVC之间的差异随阻塞程度的增加而增加。气道阻塞患者的过度充气取决于阻塞程度（FEV1）以及强制动作和慢动作之间的肺活量差异。简介欧洲呼吸学会（1）建立了三种测量肺活量（VC）的方法：呼吸肺活量（IVC），呼气肺活量（EVC）和强迫肺活量（FVC）。 IVC从剩余容积（RV）的缓慢操纵开始，到总肺活量（TLC）结束。 EVC首先是TLC的缓慢动作，然后是RV。与前两个相反，FVC包含从TLC开始到RV结束的强制机动。在健康的年轻个体中，缓慢的肺活量和强迫肺活量之间的差异实际上为零（2），而在有气流阻塞的患者中，这可能很重要。因此，欧洲呼吸学会建议使用慢速操作来测量肺活量（1）。 RV由胸壁的弹性特性（3）和呼气气流限制（4）决定。在健康个体中，RV主要由该属性决定，但是在出现气流受限的患者中，呼气流量的减少将导致动态过度充气和RV增加。当前，体积和流量的确定通常是基于强迫呼吸。值得注意的是，FVC和慢速VC之间的差异与强制呼气期间的过度充气有关（2,4），但是在这方面文献资料很少（5）。我们研究的目的是评估通过慢速操作与强制操作测得的肺活量差异（dVC）与恶性通货膨胀之间的关系。我们还研究了这种差异的预测价值，以此作为通过缓慢动作确定的恶性通货膨胀程度的标志。方法我们研究了162名连续性患者，这些患者被转诊至一家功能检查实验室，怀疑患有阻塞性肺疾病（哮喘或慢性阻塞性肺疾病–COPD-）。在所有患者中，除了肺活量测定外，还确定了肺容量。分别高于预测FEV1和FEV1 / FVC的80％和70％的所有值均被视为正常。帕蒂

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