Ben Knox-Brown, Chara Alexiou, Sanja Stanojevic, Karl P Sylvester
{"title":"利用肺活量测定法和单次呼吸气体转移测量来识别低总肺活量。","authors":"Ben Knox-Brown, Chara Alexiou, Sanja Stanojevic, Karl P Sylvester","doi":"10.1183/23120541.00038-2025","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Measurement of total lung capacity (TLC) requires large and expensive equipment. We aimed to investigate whether spirometric restriction and low alveolar volume measured by single breath gas transfer (<i>V</i> <sub>A</sub>) can be used to identify those with a low TLC.</p><p><strong>Methods: </strong>We retrospectively analysed data from adults referred to Cambridge University Hospitals between January 2016 and December 2023. We investigated the utility of spirometric restriction (forced vital capacity (FVC) < lower limit of normal (LLN) with forced expiratory volume in 1 s /FVC ≥LLN) and reduced <i>V</i> <sub>A</sub> (<LLN), to discriminate low TLC measured by plethysmography (TLC<sub>pleth</sub> <LLN). We assessed agreement between definitions using the Cohen's kappa coefficient and the discriminative ability of spirometric restriction and reduced <i>V</i> <sub>A</sub> to identify TLC<sub>pleth</sub> <LLN.</p><p><strong>Results: </strong>Data from 7923 patients were included. The majority (94%) of patients were of European ancestry, 51% were female. Mean age was 58 years. 11% of patients had a TLC<sub>pleth</sub> <LLN, of which 27% also had spirometric restriction, and 95% had a <i>V</i> <sub>A</sub> <LLN. Agreement between spirometric restriction and TLC<sub>pleth</sub> <LLN was fair (κ=0.37). Spirometric restriction had low sensitivity (27%) but high specificity (99%) for discriminating TLC<sub>pleth</sub> <LLN. Agreement between <i>V</i> <sub>A</sub> <LLN and TLC<sub>pleth</sub> <LLN was substantial (κ=0.63). <i>V</i> <sub>A</sub> <LLN had good sensitivity (95%) and specificity (89%) for discriminating TLC<sub>pleth</sub> <LLN, except for in patients with the most severe airflow obstruction.</p><p><strong>Conclusions: </strong>A FVC in the healthy range is an effective tool for ruling out restriction. Low <i>V</i> <sub>A</sub> can be used to accurately identify those with a low TLC, negating the need for formal measurement of static lung volumes when identifying restrictive lung disease.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415716/pdf/","citationCount":"0","resultStr":"{\"title\":\"The utility of spirometry and single breath gas transfer measurements to identify low total lung capacity.\",\"authors\":\"Ben Knox-Brown, Chara Alexiou, Sanja Stanojevic, Karl P Sylvester\",\"doi\":\"10.1183/23120541.00038-2025\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Measurement of total lung capacity (TLC) requires large and expensive equipment. We aimed to investigate whether spirometric restriction and low alveolar volume measured by single breath gas transfer (<i>V</i> <sub>A</sub>) can be used to identify those with a low TLC.</p><p><strong>Methods: </strong>We retrospectively analysed data from adults referred to Cambridge University Hospitals between January 2016 and December 2023. We investigated the utility of spirometric restriction (forced vital capacity (FVC) < lower limit of normal (LLN) with forced expiratory volume in 1 s /FVC ≥LLN) and reduced <i>V</i> <sub>A</sub> (<LLN), to discriminate low TLC measured by plethysmography (TLC<sub>pleth</sub> <LLN). We assessed agreement between definitions using the Cohen's kappa coefficient and the discriminative ability of spirometric restriction and reduced <i>V</i> <sub>A</sub> to identify TLC<sub>pleth</sub> <LLN.</p><p><strong>Results: </strong>Data from 7923 patients were included. The majority (94%) of patients were of European ancestry, 51% were female. Mean age was 58 years. 11% of patients had a TLC<sub>pleth</sub> <LLN, of which 27% also had spirometric restriction, and 95% had a <i>V</i> <sub>A</sub> <LLN. Agreement between spirometric restriction and TLC<sub>pleth</sub> <LLN was fair (κ=0.37). Spirometric restriction had low sensitivity (27%) but high specificity (99%) for discriminating TLC<sub>pleth</sub> <LLN. Agreement between <i>V</i> <sub>A</sub> <LLN and TLC<sub>pleth</sub> <LLN was substantial (κ=0.63). <i>V</i> <sub>A</sub> <LLN had good sensitivity (95%) and specificity (89%) for discriminating TLC<sub>pleth</sub> <LLN, except for in patients with the most severe airflow obstruction.</p><p><strong>Conclusions: </strong>A FVC in the healthy range is an effective tool for ruling out restriction. Low <i>V</i> <sub>A</sub> can be used to accurately identify those with a low TLC, negating the need for formal measurement of static lung volumes when identifying restrictive lung disease.</p>\",\"PeriodicalId\":11739,\"journal\":{\"name\":\"ERJ Open Research\",\"volume\":\"11 5\",\"pages\":\"\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415716/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ERJ Open Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1183/23120541.00038-2025\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ERJ Open Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1183/23120541.00038-2025","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
背景：全肺容量（TLC）的测量需要大型和昂贵的设备。我们的目的是研究单次呼吸气体传输（va）测量的肺泡容积和呼吸受限是否可以用于鉴别TLC低的患者。方法：我们回顾性分析2016年1月至2023年12月在剑桥大学医院转诊的成人数据。我们研究了肺活量限制(用力肺活量（FVC) <正常下限（LLN），用力呼气量为1 s /FVC≥LLN）和降低V A（容积V A）识别tlpleth的有效性。大多数（94%）患者为欧洲血统，51%为女性。平均年龄58岁。结论：健康范围内的FVC是排除限制的有效工具。低V A可用于准确识别低TLC患者，在识别限制性肺部疾病时无需正式测量静态肺容积。
The utility of spirometry and single breath gas transfer measurements to identify low total lung capacity.
Background: Measurement of total lung capacity (TLC) requires large and expensive equipment. We aimed to investigate whether spirometric restriction and low alveolar volume measured by single breath gas transfer (VA) can be used to identify those with a low TLC.
Methods: We retrospectively analysed data from adults referred to Cambridge University Hospitals between January 2016 and December 2023. We investigated the utility of spirometric restriction (forced vital capacity (FVC) < lower limit of normal (LLN) with forced expiratory volume in 1 s /FVC ≥LLN) and reduced VA (pleth V A to identify TLCpleth
Results: Data from 7923 patients were included. The majority (94%) of patients were of European ancestry, 51% were female. Mean age was 58 years. 11% of patients had a TLCplethV Apleth pleth V Apleth V Apleth
Conclusions: A FVC in the healthy range is an effective tool for ruling out restriction. Low VA can be used to accurately identify those with a low TLC, negating the need for formal measurement of static lung volumes when identifying restrictive lung disease.
期刊介绍：
ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.
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