https://scholars.lib.ntu.edu.tw/handle/123456789/530850
標題: | Severity staging of chronic obstructive pulmonary disease: Differences in pre- and post-bronchodilator spirometry | 作者: | Lin S.-H. PING-HUNG KUO Kuo S.-H. PAN-CHYR YANG |
公開日期: | 2009 | 卷: | 50 | 期: | 5 | 起(迄)頁: | 672-676 | 來源出版物: | Yonsei Medical Journal | 摘要: | Purpose: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for chronic obstructive pulmonary disease (COPD) uses the post-bronchodilator spirometry for diagnosis and severity staging. We evaluated differences in the severity classification of COPD, based on pre- and post-bronchodilator spirometry. Materials and Methods: From 2000 to 2004, 207 COPD patients who underwent spirometry before and after inhalation of 400 μg of fenoterol were analyzed. A responder to the bronchodilator test (BDT) was defined by the American Thoracic Society (ATS) as an increase in forced expiratory volume in one second (FEV1) or forced vital capacity ? 12% and ? 200 mL, and by the European Respiratory Society (ERS) as an increase in FEV1 ? 10% of the predicted value. COPD severity was classified according to the 2008 GOLD guidelines. Results: For the entire study population, the FEV1 increased by 11.8 ± 12.5% of baseline after BDT and 41.1% and 27.1% of subjects were classified as responders using the ATS and ERS criteria, respectively. Based on pre-BDT spirometry, 55, 85, 58, and 9 patients were classified as Stage I-IV COPD, respectively. Sixty-seven (32.4%) patients changed severity staging after BDT, including 20.0%, 28.2%, 44.8%, and 66.7% of pre-BDT patients Stages I through IV, respectively. More ATS or ERS BDT-responders had a change in severity staging than non-responders (52.9% vs. 18.9% and 62.5% vs. 21.2%, both p < 0.001). Conclusion: Our data suggest that the severity staging of COPD using pre-BDT spirometry might lead to significant differences as compared to staging, based on post-BDT spirometry, as recommended by the current GOLD guidelines. ? Copyright: Yonsei University College of Medicine 2009. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-70449724677&doi=10.3349%2fymj.2009.50.5.672&partnerID=40&md5=24517406e4fc42d4b758cfbd13d65d78 https://scholars.lib.ntu.edu.tw/handle/123456789/530850 |
ISSN: | 0513-5796 | DOI: | 10.3349/ymj.2009.50.5.672 | SDG/關鍵字: | fenoterol; aged; article; bronchodilatation; bronchospirography; chronic obstructive lung disease; controlled study; disease classification; disease severity; female; forced expiratory volume; human; inhalation test; major clinical study; male; practice guideline; Bronchodilator Agents; Fenoterol; Forced Expiratory Volume; Humans; Practice Guidelines as Topic; Prognosis; Pulmonary Disease, Chronic Obstructive; Spirometry |
顯示於: | 醫學系 |
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