Espirograma espiratorio forzado: analisis y valor diagnostico en la obstruccion leve de la via aerea
Evaluation and diagnostic value of forced expiratory spirograms in mild airways obstruction
S. Romero Candeira, E. Delgado Perez, J. Picher Nuñez, D. Ferrer Marin-Blazquez, J. Jaurena Chury, S. Garcia Rull
Centro Especial «Ramón y Cajal» de la S. S. Servicio de Neumología. Madrid
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"apellidos" => "Picher Nuñez" ] 3 => array:2 [ "nombre" => "D." "apellidos" => "Ferrer Marin-Blazquez" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Jaurena Chury" ] 5 => array:2 [ "nombre" => "S." "apellidos" => "Garcia Rull" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Centro Especial «Ramón y Cajal» de la S. S. Servicio de Neumología. Madrid" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Evaluation and diagnostic value of forced expiratory spirograms in mild airways obstruction" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1980-10-06" "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="absec0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se estudió un grupo de 87 sujetos jóvenes considerados sanos, utilizando un sistema automatizado de medida y cálculo, en un intento de determinar los patrones adecuados de normalidad, la influencia del sistema de selección de medida sobre los valores de los flujos máximos y la sensibilidad de los diferentes parámetros del espirograma espiratorio forzado en la discriminación de alteraciones de la pequeña vía debidas al hábito de fumar.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En los 52 sujetos no fumadores, los valores obtenidos para los flujos meso y telespiratorios presentaban discrepancias significativas con los valores de referencia previamente introducidos en el programador.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Los valores promedio de FEV<span class="elsevierStyleInf">1</span>/FVC, MEF<span class="elsevierStyleInf">50</span>, FEF<span class="elsevierStyleInf">25-75</span>, MEF<span class="elsevierStyleInf">75</span> y FEF<span class="elsevierStyleInf">75-85</span> sirvieron para diferenciar los grupos de fumadores y no fumadores, sin que, en el caso de las mujeres, con una historia de tabaco más corta, las diferencias alcanzaran significación estadística.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Al aplicar a los resultados obtenidos los límites preestablecidos de normalidad no se apreció superioridad valorable de los parámetros mesoespiratorios sobre la relación FEV1/FVC, en cuanto a especificidad ni sensibilidad. La falta de especificidad de los flujos telespiratorios impidió el aprovechamiento de su mayor sensibilidad con fines discriminatorios.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">De estos resultados parece deducirse que, en ausencia de líneas de regresión propias, el considerar como anormal a un individuo basándose en un determinado valor de un flujo máximo a bajo volumen pulmonar, es arriesgado, y que la hipotética superioridad de la zona del espirograma espiratorio forzado catalogada como «esfuerzo independiente», en la detección de grados menores de obstrucción de la vía respiratoria, es difícilmente demostrable.</p></span>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span id="absec0010" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A group of 87 young apparently healthy individuáis were tested with a computerized measuring and calculating system in an attempt to determine adecuade normal patterns of maximal flow volume, the influence exerted by different test instruments and the sensitivity of torced expiratory spirogram parameters for detecting small airways alterations in cigarette smokers. Of the 87 individuáis taking part in the study, 52 were non-smokers and the remaining 35 smokers. A significant difference was seen between the pre-established reference valúes and médium flow and tele-expiration valúes in the group of non-smokers.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Mean valúes of FEV<span class="elsevierStyleInf">1</span>/FVC, MEF<span class="elsevierStyleInf">50</span>, FEF<span class="elsevierStyleInf">25-75</span>, MEF<span class="elsevierStyleInf">75</span> and FEF<span class="elsevierStyleInf">75-85</span> were different for smokers and non-smokers, although the valúes for women were not statistically different, presumably because the women had been smoking a shorter time than the men.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">When results were compared to the pre-established normal limits, the increase in médium flow parameters over the FEV/FVC relation was so slight as to be immeasurable in either sensitivity or specificity. Although the sensitivity of tele-expiratory flow volumes is high, it was not specific and could not be used for differentiation.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">These results suggest that in the absence of proper regression lines a determined maximal flow valué at low pulmonary volume cannot be an indicator of anomalities and the forced expiratory spirogram zone known as «independent effort» zone is not a reliable detector of mild airways obstruction.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The maximum expiratory flow-volume in the evaluation of patients with lung disease. 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Cherniak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/arrd.1975.112.3.407" "Revista" => array:5 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1975" "volumen" => "112" "paginaInicial" => "407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1163894" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intrasubject variability of maximal expiratory flow-volume curve" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.M. Cochrane" 1 => "F. Prieto" 2 => "T.J.H. Clark" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Thorax" "fecha" => "1977" "volumen" => "32" "paginaInicial" => "171" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/867329" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effort independence and forced expiratory flow" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B.J. Sobol" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "End of an era?. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 1 | 5 |
| 2024 October | 43 | 20 | 63 |
| 2024 September | 34 | 26 | 60 |
| 2024 August | 44 | 39 | 83 |
| 2024 July | 27 | 20 | 47 |
| 2024 June | 50 | 18 | 68 |
| 2024 May | 31 | 25 | 56 |
| 2024 April | 48 | 17 | 65 |
| 2024 March | 35 | 14 | 49 |
| 2024 February | 23 | 31 | 54 |
| 2023 March | 7 | 7 | 14 |
| 2023 February | 20 | 20 | 40 |
| 2023 January | 18 | 22 | 40 |
| 2022 December | 24 | 20 | 44 |
| 2022 November | 30 | 11 | 41 |
| 2022 October | 21 | 27 | 48 |
| 2022 September | 22 | 19 | 41 |
| 2022 August | 28 | 33 | 61 |
| 2022 July | 25 | 37 | 62 |
| 2022 June | 24 | 32 | 56 |
| 2022 May | 20 | 46 | 66 |
| 2022 April | 35 | 25 | 60 |
| 2022 March | 55 | 31 | 86 |
| 2022 February | 38 | 17 | 55 |
| 2022 January | 30 | 24 | 54 |
| 2021 December | 15 | 20 | 35 |
| 2021 November | 16 | 24 | 40 |
| 2021 October | 19 | 24 | 43 |
| 2021 September | 14 | 31 | 45 |
| 2021 August | 5 | 25 | 30 |
| 2021 July | 10 | 22 | 32 |
| 2021 June | 13 | 29 | 42 |
| 2021 May | 14 | 29 | 43 |
| 2021 April | 15 | 36 | 51 |
| 2021 March | 30 | 10 | 40 |
| 2021 February | 36 | 10 | 46 |
| 2021 January | 16 | 20 | 36 |
| 2020 December | 21 | 7 | 28 |
| 2020 November | 6 | 18 | 24 |
| 2020 October | 10 | 7 | 17 |
| 2020 September | 6 | 7 | 13 |
| 2020 August | 12 | 10 | 22 |
| 2020 July | 20 | 13 | 33 |
| 2020 June | 15 | 4 | 19 |
| 2020 May | 12 | 11 | 23 |
| 2020 April | 13 | 4 | 17 |
| 2020 March | 16 | 13 | 29 |
| 2020 February | 13 | 12 | 25 |
| 2020 January | 23 | 9 | 32 |
| 2019 December | 24 | 11 | 35 |
| 2019 November | 12 | 5 | 17 |
| 2019 October | 8 | 4 | 12 |
| 2019 September | 11 | 17 | 28 |
| 2019 August | 8 | 8 | 16 |
| 2019 July | 11 | 16 | 27 |
| 2019 June | 8 | 11 | 19 |
| 2019 May | 16 | 10 | 26 |
| 2019 April | 50 | 12 | 62 |
| 2019 March | 8 | 14 | 22 |
| 2019 February | 5 | 8 | 13 |
| 2019 January | 2 | 4 | 6 |
| 2018 December | 7 | 8 | 15 |
| 2018 November | 8 | 16 | 24 |
| 2018 October | 17 | 11 | 28 |
| 2018 September | 12 | 2 | 14 |
| 2018 May | 11 | 1 | 12 |
| 2018 April | 7 | 4 | 11 |
| 2018 March | 5 | 4 | 9 |
| 2018 February | 7 | 10 | 17 |
| 2018 January | 6 | 8 | 14 |
| 2017 December | 3 | 14 | 17 |
| 2017 November | 7 | 21 | 28 |
| 2017 October | 7 | 12 | 19 |
| 2017 September | 6 | 15 | 21 |
| 2017 August | 7 | 13 | 20 |
| 2017 July | 3 | 8 | 11 |
| 2017 June | 8 | 26 | 34 |
| 2017 May | 9 | 24 | 33 |
| 2017 April | 11 | 22 | 33 |
| 2017 March | 7 | 9 | 16 |
| 2017 February | 7 | 10 | 17 |
| 2017 January | 2 | 9 | 11 |
| 2016 December | 14 | 16 | 30 |
| 2016 November | 17 | 29 | 46 |
| 2016 October | 19 | 28 | 47 |
| 2016 September | 34 | 16 | 50 |
| 2016 August | 32 | 12 | 44 |
| 2016 July | 36 | 8 | 44 |
| 2016 June | 28 | 11 | 39 |
| 2016 May | 24 | 6 | 30 |
| 2016 April | 8 | 0 | 8 |
| 2016 March | 13 | 0 | 13 |
| 2016 February | 33 | 1 | 34 |
| 2016 January | 26 | 7 | 33 |
| 2015 December | 29 | 12 | 41 |
| 2015 November | 32 | 7 | 39 |
| 2015 October | 4 | 1 | 5 |
| 2015 September | 1 | 0 | 1 |
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