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DOI: 10.1055/s-0029-1242688
© Georg Thieme Verlag KG Stuttgart · New York
Referenzwerte für die Spirometrie bei Erwachsenen
Ergebnisse der „Study of Health in Pomerania” (SHIP)Reference values for lung function testing in adults Results from the „Study of Health in Pomerania” (SHIP)Publikationsverlauf
eingereicht: 10.3.2009
akzeptiert: 23.7.2009
Publikationsdatum:
05. November 2009 (online)

Zusammenfassung
Einleitung: Die Spirometrie ist eine pneumologische Untersuchung mit weitreichenden therapeutischen, diagnostischen und prognostischen Implikationen. Ziel der vorliegenden Arbeit war die Erstellung von aktuellen Referenzwerten für die Lungenfunktion an einer repräsentativen Population in Mecklenburg-Vorpommern und darüber hinaus der Vergleich zu bereits existierenden Daten.
Methodik: 1809 freiwillige Personen (885 Männer, 924 Frauen) einer großen epidemiologischen Querschnittstudie – Study of Health in Pomerania (SHIP) – nahmen an der Spirometrie teil.
Ergebnisse: Probanden mit Herzerkrankungen, Raucher und Personen mit spezifischer, die Lungenfunktion potentiell beeinflussender Medikation, wurden bei der Datenauswertung nicht berücksichtigt, so dass Daten von 904 Probanden in die Studie einflossen. Die statistische Auswertung erfolgte anhand von Quantilregression.
Folgerung: Aktuelle geschlechtsspezifische Normwertgleichungen können zu der Interpretation von Lungenfunktionsuntersuchungen beitragen. Durch die Übertragung der erhobenen Daten auf existierende Referenzwerte ergab sich eine deutliche Unterschätzung der untersuchten Probanden hinsichtlich ihrer Lungenfunktion, so dass die Überarbeitung der international anerkannten Normwerte für die Spirometrie dringend zu empfehlen ist.
Summary
Background and objective: The assessment of lung function with spirometry is a frequently performed diagnostic procedure and is considered an important tool in medical monitoring of pulmonary diseases. This study aimed at establishing current reference standards, derived from a representative population sample in West Pomerania of Germany and to compare them to existing data.
Patients and Methods: Standardized spirometric function tests were performed - 1sec forced respiratory volume (FEV1) and forced vital capacity (FVC) - on 1,809 participants (885 men, 924 women) of a cross-sectional epidemiological survey, called Study of Health in Pomerania ( SHIP).
Results: All persons with cardiac disorders, current smokers and those who were on specific medication which could influence lung functions were excluded, leaving a total of 904 healthy subjects (439 men, 465 women, aged 25-85 years. The results were analysed by quantile regression.
Conclusion: The study provides a representative, gender specific set of predictive equations for lung function parameters by spirometry. Comparison to existing prediction equations revealed a consistent underestimation in the current population. The results help to interpret the results of lung function tests: it is therefore recommended that the existing prediction equations be revised.
Schlüsselwörter
Lungenfunktionstest - Spirometrie - Referenzwerte - Erwachsene - Study of Health in Pomerania
Keywords
lung function tests - spirometry - reference values - adults - Study of Health in Pomerania
Literatur
- 1
American Thoracic
Society .
Lung function testing: selection of reference
values and interpretative strategies.
Am Rev Respir Dis.
1991;
144
1202-1218
MissingFormLabel
- 2
Statement of the American
Thoracic Society .
Standardization of spirometry – 1987
update.
Am Rev Respir Dis.
1987;
136
1285-1298
MissingFormLabel
- 3
American Thoracic Society .
Standardization of Spirometry, 1994 Update.
Am J Respir
Crit Care Med.
1995;
152
1107-1136
MissingFormLabel
- 4
Brandli O, Schindler C, Kunzli N, Keller R, Perruchoud A P.
Lung function in healthy never smoking adults: reference values
and lower limits of normal of a Swiss population.
Thorax.
1996;
51
277-283
MissingFormLabel
- 5
Crapo R O, Morris A H, Gardner R M.
Reference spirometric values using techniques
and equipment that meet ATS recommendations.
Am Rev Respir
Dis.
1981;
123
659-664
MissingFormLabel
- 6
Friedrich N, Alte D, Volzke H. et
al .
Reference ranges of serum IGF-1 and IGFBP-3 levels
in a general adult population: results of the Study of Health in
Pomerania (SHIP).
Growth Horm IGF Res.
2008;
18
228-237
MissingFormLabel
- 7
Gauderman W J, Vora H, McConnell R. et al .
Effect of exposure to traffic on lung development
from 10 to 18 years of age: a cohort study.
Lancet.
2007;
369
571-577
MissingFormLabel
- 8
Glindmeyer H W, Diem J E, Jones R N, Weill H.
Noncomparability
of longitudinally and cross-sectionally determined annual change
in spirometry.
Am Rev Respir Dis.
1982;
125
544-548
MissingFormLabel
- 9
John U, Greiner B, Hensel E. et
al .
Study of Health In Pomerania (SHIP): a health examination
survey in an east German region: objectives and design.
Soz
Praventivmed.
2001;
46
186-194
MissingFormLabel
- 10
Keil U, Stieber J, Doring A. et
al .
The cardiovascular risk factor profile in the study
area Augsburg. Results from the first MONICA survey 1984/85.
Acta Med Scand Suppl.
1988;
728
119-128
MissingFormLabel
- 11
Kunzli N, Kuna-Dibbert B, Keidel D. et al .
Longitudinal validity of spirometers--a
challenge in longitudinal studies.
Swiss Med Wkly.
2005;
135
503-508
MissingFormLabel
- 12
Kuster S P, Kuster D, Schindler C. et al .
Reference equations for lung function screening
of healthy never-smoking adults aged 18 – 80
years.
Eur Respir J.
2008;
31
860-868
MissingFormLabel
- 13
Nelson S B, Gardner R M, Crapo R O, Jensen R L.
Performance
evaluation of contemporary spirometers.
Chest.
1990;
97
288-297
MissingFormLabel
- 14
Pellegrino R, Viegi G, Brusasco V. et al .
Interpretative strategies for lung function
tests.
Eur Respir J.
2005;
26
948-968
MissingFormLabel
- 15
Quanjer P H, Tammeling G J, Cotes J E. et al .
Lung volumes and forced ventilatory
flows. Report Working Party Standardization of Lung Function Tests,
European Community for Steel and Coal. Official Statement of the
European Respiratory Society.
Eur Respir J Suppl.
1993;
16
5-40
MissingFormLabel
- 16
Roca J, Burgos F, Sunyer J. et
al .
References values for forced spirometry. Group
of the European Community Respiratory Health Survey.
Eur
Respir J.
1998;
11
1354-1362
MissingFormLabel
- 17
Roca J, Sanchis J, Agusti-Vidal A. et al .
Spirometric reference values from a Mediterranean
population.
Bull Eur Physiopathol Respir.
1986;
22
217-224
MissingFormLabel
- 18
Volzke H, Alte D, Kohlmann T. et al .
Reference intervals of serum thyroid function
tests in a previously iodine-deficient area.
Thyroid.
2005;
15
279-285
MissingFormLabel
- 19
Xu X, Laird N, Dockery D W. et al .
Age, period, and cohort effects on pulmonary
function in a 24-year longitudinal study.
Am J Epidemiol.
1995;
141
554-566
MissingFormLabel
Beate Koch
Klinik
für Innere Medizin B, Bereiche Kardiologie, Pneumologie,
Infektiologie und Internistische Intensivmedizin
Friedrich-Loeffler-Str.
23
17475 Greifswald
Telefon: 03834/867242
eMail: beate.koch@uni-greifswald.de