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  • Pneumonologia Polska
  • Tom 3, Nr 3 (2022) Wieloetniczne wartości należne parametrów badania spirometrycznego w zakresie wiekowym 3–95 lat: obowiązujące globalnie równania służące ocenie czynności układu oddechowego 2012
Tom 3, Nr 3 (2022)
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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Wieloetniczne wartości należne parametrów badania spirometrycznego w zakresie wiekowym 3–95 lat: obowiązujące globalnie równania służące ocenie czynności układu oddechowego 2012

Philip H. Quanjer1, Sanja Stanojevic23, Tim J. Cole4, Xaver Baur5, Graham L. Hall6, Bruce H. Culver7, Paul L. Enright8, John L. Hankinson9, Mary S.M. Ip10, Jinping Zheng11, Janet Stocks2, Globalna inicjatywa oceny czynności ukła (Global Lung Function Initiative) ERS
Pneum Pol 2022;3(3):76-103.

Streszczenie

Celem Grupy Roboczej było opracowanie ciągłych równań predykcyjnych oraz ich dolnych granic wartości prawidłowych dla wskaźników spirometrycznych, które miałyby zastosowanie na całym świecie. Globalna inicjatywa oceny czynności układu oddechowego Europejskiego Towarzystwa Pulmonologicznego uzyskała dostęp do ponad 160000 punktów danych pochodzących z 72 ośrodków w 33 krajach. Po wyeliminowaniu danych, które nie mogły być wykorzystane (głównie brakujące dane dotyczące grupy etnicznej, występowanie danych odstających) pozostało 97759 danych jednostkowych uzyskanych od zdrowych osób niepalących (55,3% kobiet) w wieku 2,5–95 lat.

Dane dotyczące czynności układu oddechowego zostały połączone i opracowano równania predykcyjne z zastosowaniem metody LMS, która umożliwia jednoczesne modelowanie średniej (µ), współczynnika zmienności (ς) i współczynnika skośności (λ) dla rodziny rozkładów.

Po odrzuceniu 23572 rekordów, głównie z powodu braku możliwości połączenia ich z innymi grupami etnicznymi lub geograficznymi, opracowano równania referencyjne dla zdrowych osób w wieku 3–95 lat rasy kaukaskiej (n = 57395), afroamerykańskiej (n = 3545) oraz północno- (n = 4992) i południowo-wschodnio-azjatyckiej (n = 8255). Wartości natężonej objętości wydechowej pierwszosekundowej (FEV1) oraz natężonej pojemności życiowej (FVC) różniły się proporcjonalnie pomiędzy grupami etnicznymi w porównaniu z rasą kaukaską, tak że wartość FEV1/FVC pozostawała praktycznie niezależna od grupy etnicznej. W przypadku osób, które nie były reprezentowane przez wymienione cztery grupy etniczne lub osób o mieszanym pochodzeniu etnicznym, w celu ułatwienia interpretacji do czasu opracowania bardziej odpowiedniego rozwiązania przedstawiono złożone równanie uzyskane z uśrednienia powyższych równań.

Obecnie dostępne są równania predykcyjne dla parametrów badania spirometrycznego w przedziale wiekowym 3–95 lat, które obejmują odpowiednie zależne od wieku dolne granice wartości prawidłowych. Mogą być one stosowane na całym świecie w odniesieniu do różnych grup etnicznych. Dodatkowe dane pochodzące z subkontynentu indyjskiego oraz krajów arabskich, polinezyjskich i latynoamerykańskich, a także z Afryki, przyczynią się do dalszego udoskonalenia tych równań.

Słowa kluczowe: dolna granica normywartości należnespirometriamodelowanie statystycznez-score

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