Studies of normal values and prediction equations for pulmonary function--spirometry and flow-volume measurements in healthy Japanese children 6 to 14 years of age

We analyzed spirometric data (spirograms and flow-volume curves) on 1,357 healthy Japanese children (6-14 yr, 709 males and 648 females) in Higashimatsuyama, Saitama. The area was selected as the representative of the less polluted area in Japan, as we intended to exclude possible effects of air-pollution on spirometric values. Hot-wire anaemometers (AS 3500, AS 4500, MINATO) were used in the spirometry and the test procedures were done following the American Thoracic Society recommendations. By multiple regression analysis prediction equations were obtained for VC, FVC, FEV1, FEV1/FVC (%), MMFR, PEFR (Peak Expiratory Flow Rate), V75, V50, and V25. The selected variables were height and weight for VC, FVC and FEV1 but only height for MMFR, PEFR, V75, V50 and V25. Since there was no significant correlations between FEV1/FVC (%) and these variables, we defined normal ranges for FEV1/FVC (%). The predicted values derived from our equations were larger than those obtained from the other studies published in Japan. The difference is probably due to the improvement in the body size of Japanese children and the equipments used.     

Spirometric standards for healthy children and adolescents of Korean Chinese in northeast China

In China there are 1,923,842 Korean Chinese, who live mostly (92.27%) in the country's three northeast provinces. In spite of this sizeable number, no spirometric data are available at present on them. The present study investigated normal spirometric reference values for the Korean Chinese children and adolescents. Spirometry was performed in 443 healthy Korean Chinese children and adolescents aged 8-18 yr with measurements of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF) and maximum mid-expiratory flow (MMEF). Reference equations for FEV1, FVC, PEF and MMEF were derived by using multiple regression analysis. All of the measured spirometric parameters correlated positively with height and age significantly (P < 0.001). The predicted values of FVC and FEV1 were higher than values obtained by using Caucasian and other Asian equations (P < 0.001). A set of spirometric reference equations has been derived using a relatively large, healthy, non-smoking young Korean Chinese population with a wide range of ages and heights, the results of which differ from those gained from several other reference equations. These reference equations should be used for evaluation of lung function in this population.     

Airway Measurement for Airway Remodeling Defined by Post-Bronchodilator FEV1/FVC in Asthma: Investigation Using Inspiration-Expiration Computed Tomography

Purpose

Airway remodeling may be responsible for irreversible airway obstruction in asthma, and a low post-bronchodilator FEV1/FVC ratio can be used as a noninvasive marker of airway remodeling. We investigated correlations between airway wall indices on computed tomography (CT) and various clinical indices, including post-bronchodilator FEV1/FVC ratio, in patients with asthma.

Methods

Volumetric CT was performed on 22 stable asthma patients who were taking inhaled corticosteroids. Airway dimensions were measured at four segmental bronchi using in-house software based on the full-width/half-maximum method. Parameters included luminal area, wall thickness (WT), wall thickness percentage (WT%), wall area percentage (WA%), bronchial-to-arterial diameter (BA) ratio on inspiration CT, airway collapsibility (AC), and air trapping index (ATI). Correlations were analyzed between CT parameters and clinical indices, including %FEV1, FEV1/FVC, FEF_25-75%, and post-bronchodilator FEV1/FVC ratio.

Results

Post-bronchodilator FEV1/FVC showed significant correlations with WT%, WT, BA ratio, AC, and ATI (r=-0.503, -0.576, 0.454, 0.475, and -0.610, respectively). WT showed negative correlations with FEV1/FVC and FEF_25-75% (r=-0.431 and -0.581), and WT% was negatively correlated with %FEV1, FEV1/FVC, and FEF_25-75% (r=-0.434, -0.431, and -0.540, respectively). WA% showed correlations with FEF_25-75% and body mass index (r=-0.459 and 0.453). The BA ratio was positively correlated with %FEV1 (r=0.459) and FEF_25-75% (r=0.479). AC showed strong positive correlation with FEV1/FVC (r=0.592), and ATI showed negative correlations with FEV1/FVC (r=-0.534) and FEF_25-75% (r=-0.591).

Conclusions

WT%, WT, BA ratio, and AC on inspiration and expiration CT are good indices for measuring airway remodeling defined by post-bronchodilator FEV1/FVC in stable asthma patients treated with inhaled corticosteroids.     

Effect of occupational exposure and smoking on spirometric tests and symptoms of chronic bronchitis

The importance of occupational exposure to airborne agents in the development of obstructive lung disease is uncertain. The aim of the study was to evaluate the effects of smoking and of occupational exposure on the lung function and chronic respiratory symptoms. I studied a group of 1239 adults (766 men and 473 women; mean age 44.9 +/- 8.6 yrs; current smokers 42.1%, lifetime nonsmokers 41.6%) working in 5 factories in the Bielsko-Biala area. Simple spirometric test (FEV1, FVC, FEV1%FVC) and a questionnaire on chronic respiratory symptoms, smoking habits and occupational exposures were applied. Respiratory symptoms and lung function were studied in relation to years of occupational exposure and adjusted for smoking habit. Occupational exposure was reported by 35.7% (n = 442) participants (dust 20.6%; gases or fumes 27.6%; mixed exposure 51.8%), with a mean duration of 20.9 +/- 9.2 years. In all cases concentrations of noxious agents did not exceed allowed levels. The symptoms of chronic bronchitis (cough and phlegm) were present in 12.3% and airflow limitation (FEV1% FVC < 0.7) in 6.9% of subjects. The significant relation of respiratory symptoms and bronchial obstruction to smoking was confirmed. No significant association between occupational exposure and ventilatory function or respiratory symptoms was found in a whole group. Smoking--specific analysis showed that current smokers appeared to be more susceptible to the effects of professional exposure. It was expressed in lower lung function indices and significantly higher odds ratios for airflow limitation or chronic respiratory symptoms for smokers exposed compared to nonexposed. Sufficient evidence of health selection processes known as a "healthy smoker" and a "healthy worker" effects were revealed.     

Genome-wide linkage analysis of bronchodilator responsiveness and post-bronchodilator spirometric phenotypes in chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a common, complex disease associated with significant and increasing morbidity and mortality. The cardinal feature of COPD is persistent airflow obstruction, measured by reductions in quantitative spirometric indices including forced expiratory volume at one second (FEV(1)) and the ratio of FEV(1) to forced vital capacity (FEV(1)/FVC). However, many patients have substantial improvement in spirometric measures with inhaled bronchodilator medications, and bronchodilator responsiveness (BDR) has been associated with disease severity and progression. To identify susceptibility loci for BDR phenotypes, we performed a 9 cM genome scan in 72 pedigrees (n=560 members) ascertained through probands with severe, early-onset COPD. Multipoint variance component linkage analysis was performed for quantitative phenotypes including BDR measures and post-bronchodilator FEV(1) and FEV(1)/FVC. Post-bronchodilator FEV(1) was linked to multiple regions, most significantly to markers on chromosome 8p (LOD=3.30) and 1q (LOD=2.24). Post-bronchodilator FEV(1)/FVC was also linked to multiple regions, most significantly to markers on chromosome 2q (LOD=4.42) and 1q (LOD=2.52). When compared with pre-bronchodilator spirometric indices, the post-bronchodilator values demonstrated increased evidence of linkage in multiple genomic regions. In particular, the LOD score for the 8p linkage to FEV(1) roughly doubled from 1.58 to 3.30. Candidate regions on chromosomes 4p (LOD=1.28), 4q (LOD=1.56), and 3q (LOD=1.50) gave the strongest evidence for linkage to BDR measures. Our results provide evidence for significant linkage to airflow obstruction susceptibility loci on chromosomes 2q and 8p, and further suggest that post-bronchodilator spirometric measures are optimal phenotypes for COPD genetic studies. This study has also identified several genomic regions that could contain loci regulating BDR in early-onset COPD families.     

Spirometric reference values for children and adolescents from Kazakhstan

BACKGROUND: Spirometric parameters are influenced by several factors and many reference data are available in the literature. However, no spirometric data are available for children and adolescents from Central Asia. AIM: The study aimed to calculate spirometric reference curves on the basis of anthropometry, ethnicity (Kazakh vs. Russian) and living environment (urban vs. rural). SUBJECTS AND METHODS: Spirometry (FEV1, FVC and FEF25-75%) was performed and anthropometric measurements taken for 1926 male and 1967 female Kazakh children aged 7-18 years. RESULTS: Height explained almost all the variance of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) for both sexes, while age and inspiratory circumference contributed slightly to the prediction. Moreover, FVC and FEV1 were greater in Russians than in Kazakhs and ethnicity did enter the prediction model for these parameters. The living environment had a marginal effect on spirometry. In fact, forced expiratory flow 25-75% (FEF25-75%) was slightly higher in urban than in rural females, FVC was slightly higher in rural than in urban males, while FEV1 was not affected. Finally, among several spirometric equations available in the literature, those performing better in our children were obtained in developed countries. CONCLUSION: Anthropometry was the most important predictor of spirometry. Age and ethnicity were also predictors, while the contribution of the living environment was more limited.     

Spirometry values in Himalayan high altitude residents (Sherpas)

We compared the spirometric values of the isolated racial group of Himalayan Sherpas with those predicted for the European Coal and Steel Community (EC&S). 146 normal adult Sherpas (64 males, 82 females) and 103 adolescents (37 females and 66 males, age 10-18 years) resident at an altitude of 3,840 m were studied. Predicted values for each adult individual were calculated using the EC&S reference equations and separate Caucasian values for children were used, and new predictive equations for the Sherpa population derived. The FEV(1) of boys, adult male and female Sherpas are all significantly greater than predicted (% Predicted (PP) (95% Confidence Interval (CI)), 113% (110-116), 110% (107-114) and 116% (112-121), P < 0.0001 for all groups) as is forced vital capacity (FVC) (112% (111-119), 113% (109-117) and 121% (117-125) respectively, P < 0.0001 for all groups). Sherpa girls displayed a smaller difference in FEV(1) and FVC (PP(CI), 104% (99-109) P<0.1 and 108% (103-114) P = 0.005, respectively). We conclude that the Sherpa race has significantly larger spirometric values than Caucasians. We speculate that this is an adaptation in response to chronic hypoxia and high levels of habitual exercise.     

The effects of hormone therapy on pulmonary function tests in postmenopausal women

OBJECTIVE: To investigate the effects of hormone therapy (HT) administered to postmenopausal women on pulmonary function tests (PFT). METHODS: Eighty-two postmenopausal women who were having natural or surgically initiated menopause and had no risk factor that could affect the respiratory system were included into this prospective, randomized study. Twenty-five women who refused to use HT were assessed as the control group (Group I). Nineteen women who accepted using HT and who were having surgically initiated menopause were given continuous estrogen (Group II), 23 were given continuous estrogen and progesterone in combination (Group III) and 15 were given cyclic estrogen and progesterone combination (Group IV). Forced expiratory volume (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow rate over 25-75% of the forced vital capacity volume and peak expiratory flow rate were assessed at the beginning of the treatment and in the third month in order to evaluate the effects of HT regimens on the women's PFT. RESULTS: A statistically significant increase was observed only in the FEV1 and FVC parameters of Group III after three months of therapy (P<0.05). The comparison between pre- and posttherapy FEV1 and FVC values showed an increase in the Group IV, but the difference was not statistically significant, while there was no difference between basal and third month FEV1 and FVC values of the group receiving estrogen only. CONCLUSIONS: It was seen that particularly continuous combined HT regimen positively affected the FEV1 and FVC parameters of the postmenopausal women.     

Pulmonary function studies in healthy non-smoking men of Calcutta

Pulmonary function measurements were made in 104 healthy non-smoking men from Calcutta with an age range of 20-59 years. Except for peak expiratory flow rate (PEFR), all the measurements were made with the help of two 9L closed-circuit type expirographs using standard spirometric techniques. PEFR was recorded by two Wright peak flow meters. Prediction formulae were derived on the basis of age and height for all the ventilatory tests except for FEV1%, FET and PEFR. These were predicted from age only. The prediction equation for VC, FVC, FEV1, FEV1%, MVVF and PEFR were reliable, but those for forced expitatory flows and time were not. The FVC and FEV1 values of the present subjects, standardized for age and height, were much lower than those of Americans, Caucasians, Europeans and Canadians but similar to those of Pakistani healthy adults. On comparison with the data reported from other parts of our country, it was revealed that the VC and FEV1 values of the current study, after adjustment of age and height, were much higher than those of southern Indians but comparable with those of north-western Indians.     

Spirometric reference values from a Mediterranean population

Maximal expiratory flow-volume (MEFV) curves were measured in 1044 healthy nonsmoking volunteers living in the Barcelona area, as part of a larger interhospital project to obtain reference values of pulmonary function tests. Forced vital capacity (FVC), one-second forced expiratory volume (FEV1), FEV1/FVC, %, forced maximal mid-expiratory flow (FEF25-75%), peak expiratory flow rate (PEF) and maximal expiratory flow at 50 and 75% of FVC (MEF50% and MEF25% respectively) were obtained and expressed at BTPS conditions. Techniques and equipments followed both the recommendations of the American Thoracic Society (ATS) and of the European Community for Coal and Steel (ECCS). Prediction equations for age 20 through 70 were calculated for both sexes from a final sample composed of 870 adult subjects, 443 males and 427 females. Simple linear equations using height, age and body weight predicted all spirometric variables as well as more complex equations except MEF25%. Logarithmic equations were proposed for MEF25% to correct for the heteroscedasticity shown in a simple linear model. To our knowledge, this study provides reliable spirometric equations from a large urban Mediterranean sample which were lacking so far in the literature.     

Spirometric reference values for children and adolescents from Kazakhstan

Background: Spirometric parameters are influenced by several factors and many reference data are available in the literature. However, no spirometric data are available for children and adolescents from Central Asia.

Aim: The study aimed to calculate spirometric reference curves on the basis of anthropometry, ethnicity (Kazakh vs. Russian) and living environment (urban vs. rural).

Subjects and methods: Spirometry (FEV1, FVC and FEF25–75%) was performed and anthropometric measurements taken for 1926 male and 1967 female Kazakh children aged 7–18 years.

Results: Height explained almost all the variance of forced vital capacity (FVC) and forced expiratory volume in 1?s (FEV1) for both sexes, while age and inspiratory circumference contributed slightly to the prediction. Moreover, FVC and FEV1 were greater in Russians than in Kazakhs and ethnicity did enter the prediction model for these parameters. The living environment had a marginal effect on spirometry. In fact, forced expiratory flow 25–75% (FEF25–75%) was slightly higher in urban than in rural females, FVC was slightly higher in rural than in urban males, while FEV1 was not affected. Finally, among several spirometric equations available in the literature, those performing better in our children were obtained in developed countries.

Conclusion: Anthropometry was the most important predictor of spirometry. Age and ethnicity were also predictors, while the contribution of the living environment was more limited.     

Airway responses to a diluent used in the methacholine challenge test.

BACKGROUND: Inhalation of diluent is often used in performing methacholine challenge tests, but its elimination has been suggested because marked falls in FEV1 after diluent inhalation have not been documented and performing this step is time-consuming. OBJECTIVE: We investigated the frequency and magnitude of response to the inhalation of diluent, and if there were any systematic effects in determining the PC20 using the baseline and postdiluent spirometric measurements. METHODS: All methacholine challenges performed during a 6-year period (N = 3,902) were reviewed retrospectively. RESULTS: The maximum increase and decrease in FEV1 and FVC from baseline were 56.3% and -41.4%, respectively, and 61.7% and -40.3%, respectively. The mean absolute changes from baseline in FEV1 and FVC were -0.018 L and -0.026 L, respectively. There was a highly significant correlation (r2 = 0.96; P < .0001) between the PC20 baseline and PC20 postdiluent values, and a mean difference of 0.041 mg/mL (P < .0001), with the PC20 postdiluent being higher. CONCLUSIONS: These data do not provide strong evidence to support either using or eliminating the diluent stage. It is clear that there are frequent and sometimes large changes in FVC and FEV1 after the inhalation of diluent containing phenol and sodium bicarbonate buffer. If a laboratory intends to report changes in airway function qualitatively (ie, positive or negative), the diluent stage may not be necessary. However, if a laboratory intends to report bronchial challenge data from inhaling methacholine in a quantitative fashion and report a continuous variable such as PC20, a diluent stage is recommended.     

Spirometric response to a bronchodilator. Reference values for healthy children and adolescents

The spirometric response to inhaled salbutamol was assessed in 492 healthy volunteers 6 to 20 yr of age. Mean and standard deviation of the changes, expressed as percentage of prebronchodilator values, were as follows: forced vital capacity (FVC): 1.7 +/- 2.8; forced expiratory volume in one second (FEV1): 3.3 +/- 3.4; (FEV1/FVC): 3.1 +/- 3.2; peak expiratory flow: 6.4 +/- 8.6; maximal mid-expiratory flow: 10.1 +/- 8.8; maximum expiratory flow at 50% of FVC: 8.8 +/- 9.5 and maximum expiratory flow at 25% of FVC: 14.0 +/- 14.7. The changes were significant (p less than 0.005) for all parameters and similar to those observed in adults.     

Pulmonary function studies in healthy school boys of West Bengal.

The establishment of normal standards of dynamic pulmonary function measurements in the form of prediction equations will serve as a remedial measure of different aspects of obstructive pulmonary diseases, especially in children. With a view to achieving the target, dynamic pulmonary function measurements were undertaken on 328 healthy school-going children of West Bengal having age ranging between 9 and 18 years. All the spirometric measurements except PEFR were taken with the help of a 9 l closed-circuit type expirograph following the methods and techniques of American Thoracic Society. PEFR was measured by Wright Peak Flow Meter. Prediction equations were derived on the basis of age and height for all the pulmonary function measurements except FEV1% and FET. The prediction equations for FVC, FEV1, MVVF, and PEFR were reliable, but relative variability of predicted FEF25-75% and FEF75-85% was very large. A comparative study of FVC, FEV1, and PEFR values of our subjects, standardized for age and height, was much closer to the boys of Delhi in FVC but higher than South Indian boys in FEV1, North and South Indian boys in PEFR. In an attempt to compare FVC and FEV1 values of our subjects with foreign populations, it is revealed that boys of our study were much lower than American (White), European, and Jordanian boys but comparable with those of Chinese and Libyan boys.     

孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的疗效

目的 探讨孟鲁司特钠联合布地奈德治疗小儿咳嗽变异性哮喘的临床疗效。方法 选择2017年2月~2018年5月我院收治的咳嗽变异性哮喘患儿90例,按照随机数字表法分为研究组和对照组,各45例。对照组给予布地奈德治疗,研究组在对照组基础上加用孟鲁司特钠治疗,比较两组第1秒用力呼气量（FEV1）、用力肺活量（FVC）、FEV1/FVC水平和临床疗效。结果 治疗后,研究组FEV1、FVC及FEV1/FVC水平高于对照组[（3.34±1.01）L vs（2.17±0.62）L、（4.23±1.31）L vs（3.19±1.05）L、（78.96±3.25）% vs（66.35±4.79）%],差异有统计学意义（P＜0.05）。研究组总有效率为91.11%,高于对照组的80.00%,差异有统计学意义（P＜0.05）。结论 孟鲁司特钠联合布地奈德治疗咳嗽变异性哮喘效果明显,促进相关症状消退,改善肺功能,快速稳定病情,为预后提供保障。     

慢性阻塞性肺疾病患者年龄及体质量指数与肺功能的关系

目的：揭示慢性阻塞性肺疾病发作期患者体质量指数（body mass index,BMI）、年龄与肺功能的关系。方法：选择慢性阻塞性肺疾病患者,测量其体质量及身高并检测其肺功能。比较营养不良组（BMI＜18.5）、正常组（18.5≤BMI＜24）、超重组（24≤BMI＜28）、肥胖组（BMI≥28）患者肺功能之间的关系;同时将患者分为老年组（年龄≥65岁）和非老年组（年龄≤64岁）,同样方法比较这两组患者的肺功能状态;检测BMI和年龄与肺功能之间的相关性。结果：营养不良组和正常组、超重组、肥胖组相比,第1秒用力呼气量占预计值的百分比（forced expiratory volume in on second, FEV1%）均存在统计学意义（P＜0.01）;正常组和超重组、肥胖组相比,FEV1%差异无统计学意义（P＞0.05）;超重组和肥胖组相比,差异无统计学意义（P＞0.05）。营养不良组与超重组、肥胖组相比,FEV1/用力肺活量（forced vital capacity, FVC）的比值差异均存在统计学意义（P＜0.01）;正常组和超重组、肥胖组相比,FEV1/FVC的差异有统计学意义（P＜0.05）。FEV1%老年组与非老年组相比,差异有统计学意义（P＞0.05）,而FEV1/FVC老年组与非老年组相比,差异有统计学意义（P＜0.05）;FEV1%和BMI呈正相关（r=0.22, P＜0.01）、FEV1/FVC和BMI呈正相关（r=0.29,P＜0.01）,年龄和FEV1%无显著相关性（r=-0.12,P＞0.05）,而年龄和FEV1/FVC呈负相关（r=-0.17, P＜0.05）。结论：慢性阻塞性肺疾病患者FEV1/FVC与患者的体质量指数和年龄均存在相关性,而体质量指数对FEV1%的影响不及对FEV1/FVC的影响,年龄对FEV1%的影响不大。     

Isometric Handgrip Exercise Training Improves Spirometric Parameters and Pulmonary Capacity

Decline in normal physiological pulmonary function has been attributed to premorbid conditions such as prehypertension. Research evidence suggests that physical activity reduces age-related decline in pulmonary function and improves the efficiency of the lungs in prehypertensive patients. However, there is a scarcity of data evidence relating to isometric exercise and pulmonary function. Furthermore, the interrelationship between the intensity and duration of isometric exercise and pulmonary function in these patients is still uncertain. Therefore, this study was undertaken to investigate the effect of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. To determine the effectiveness of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. A quasi experiment using a pre- and post-exercise method was carried out in two out-patients hospital settings. The sample comprised 192 sedentary pre-hypertensive subjects, aged between 30–50 years, that were randomly distributed into three groups of 64 participants each. The subjects performed, for 24 consecutive days, an isometric handgrip exercise at 30% Maximum Voluntary Contraction (M.V.C.). At the end of the 24 days, group one (GP1) discontinued, while group two (GP2) continued the exercise protocol for another 24 consecutive days and group three (GP3) continued with the exercise protocol for another 24 consecutive days but at 50% M.V.C. Determinants of lung function (outcomes) were Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), FEV1/FVC Ratio and Peak Expiratory Flow Rate (PEFR). The study shows that there was no statistically significant difference in the pre- and post-exercise outcomes for FEV1, FVC, FEV1/FVC Ratio and PEFR after 24 days for group 1. In group 2, there was a statistically significant difference in the FVC [(mean = 0.12 ± 0.12), (p = 0.002)], FEV1 [(mean = 0.15 ± 0.17), (p = 0.003)] and PEF [(mean = 0.85 ± 0.35), (p = 0.001)] after 48 days. In group 3, there was a statistically significant difference (p = 0.001) in all the outcomes assessed after 48 days. There was a between groups difference in favour of group 2 compared with group 1 for outcomes of FEV1 [(mean = 0.142 ± 0.68), (p = 0.005)] and PEF [(mean = 0.83 ± 0.19), (p = 0.0031)]. There was statistically significant difference in favour of group 3 compared to group 2, by increasing the exercise intensity from 30% to 50% M.V.C., for outcomes of FVC [mean change = 0.10 ± 0.052), (p = 0.005)], FEV1/FVC [mean change = 3.18 ± 0.75), (p = 0.017)] and PEF [(mean change = 0.86 ± 0.35), (p = 0.001)] after 48 days. Isometric handgrip exercise (after 48 days at 30% to 50% M.V.C.) improves outcomes of pulmonary function capacity in adults with prehypertension. Meanwhile, duration and/or increase in intensity of the isometric effort significantly contributed to the affects attained.     

Familial aggregation and heritability of asthma-associated quantitative traits in a population-based sample of nuclear families

Asthma is a common, genetically complex human disease. Elevated serum immunoglobulin E (IgE) levels, elevated blood eosinophil counts, variably reduced spirometric measures and increased airway responsiveness (AR) are physiological traits which are characteristic of asthma. We investigated the genetic and environmental components of variance of serum total and specific IgE levels, blood eosinophil counts, the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), and AR in an Australian population-based sample of 232 Caucasian nuclear families. With the exception of FVC levels, all traits were closely associated with clinical asthma in this population. Loge total serum IgE levels had a narrow-sense heritability (h2N) of 47.3% (SE = 10. 0%). Specific serum IgE levels against house dust mite and Timothy grass, measured as a RAST Index, had a h2N of 33.8% (SE = 7.3%). FEV1 levels had a h2N of 6.1% (SE = 11.6%), whilst FVC levels had a h2N of 30.6% (SE = 26.8%). AR, quantified by the loge dose-response slope to methacholine (DRS), had a h2N of 30.3% (SE = 12.3%). These data are consistent with the existence of important genetic determinants of the pathophysiological traits associated with asthma. Our study suggests that total and specific serum IgE levels, blood eosinophil counts and airways responsiveness to inhaled agonist are appropriate phenotypes for molecular investigations of the genetic susceptibility to asthma.     

吸入用沙丁胺醇联合布地奈德对COPD急性加重期的作用

目的 观察吸入用沙丁胺醇联合布地奈德对COPD急性加重期的作用。方法 选取2015年1月~2017年1月我院治疗的86例COPD急性加重期患者,随机分为观察组和对照组,每组43例。对照组在常规治疗的基础上雾化吸入布地奈德,观察组在对照组的基础上吸入用沙丁胺醇。比较两组治疗前后用力肺活量（FVC）、第1秒用力呼气容积（FEV1）,临床治疗效果。结果 治疗后,两组FVC、FEV1均高于治疗前,观察组FVC、FEV1分别为（2.08±0.57）L、（1.97±0.43）L,高于对照组的（1.69±0.49）L、（1.47±0.36）L,差异有统计学意义（P＜0.05）;观察组治疗有效率为97.67%,高于对照组的76.74%,差异有统计学意义（P＜0.05）。结论 吸入用沙丁胺醇联合布地奈德有助于改善COPD急性期患者FVC、FEV1,具有较高的疗效。