THE NORMAL RANGE OF DIURNAL CHANGES IN PEAK EXPIRATORY FLOW-RATES - RELATIONSHIP TO SYMPTOMS AND RESPIRATORY-DISEASE

被引:178
作者
QUACKENBOSS, JJ
LEBOWITZ, MD
KRZYZANOWSKI, M
机构
[1] Respiratory Sciences Division, Health Sciences Center, University of Arizona, Tucson
来源
AMERICAN REVIEW OF RESPIRATORY DISEASE | 1991年 / 143卷 / 02期
关键词
D O I
10.1164/ajrccm/143.2.323
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Measuring peak expiratory flow rates (PEFR) several times a day can provide an objective assessment of functional changes relative to environmental or occupational exposures. This report describes the pattern of diurnal changes in PEFR in a reference population, and defines ranges of "normal" between-and within-day variability. An index of diurnal changes was defined as the ratio between maximal and minimal values, where the maximal value was restricted to PEFR measured at noon or in the evening (N,E) and the minimal value was restricted to the morning or at bedtime (M,B). A ratio greater than normal represented an exaggeration of the normal diurnal pattern in PEFR. Normal limits, based on the ninety-fifth percentile in the reference population, were larger for children (130%) than for adults 15 to 35 yr of age (117%) and those older than 35 yr of age (118%). The meaningfulness of excessive diurnal changes in PEFR was examined by relating this ratio (Max/Min), and a similar measure (the amplitude percent mean) to chronic respiratory symptoms and diseases in 939 adults and children who recorded PEFR values 2 to 4 times per day for as long as 14 days. There was a strong relationship of diurnal changes in PEFR that exceed normal limits with physician-confirmed asthma (relative risk of 2.99 with Max/Min), with exertional dypsnea (Grade 2+), and with more frequent reporting of acute symptoms of wheeze, attacks of wheezing dyspnea, cough, and chest colds. In addition, those exceeding the normal limits had about 2.9 times greater risk of having a FEV1 below 80% of predicted, and nearly 7 times greater risk of being below 70%. These associations support the interpretation of excessive diurnal changes in PEFR as an indicator of bronchial responsiveness.
引用
收藏
页码:323 / 330
页数:8
相关论文
共 54 条
  • [1] VARIATION IN PEAK EXPIRATORY FLOW OF NORMAL AND ASYMPTOMATIC ASTHMATIC-CHILDREN
    ALBERTINI, M
    POLITANO, S
    BERARD, E
    BOUTTE, P
    MARIANI, R
    [J]. PEDIATRIC PULMONOLOGY, 1989, 7 (03) : 140 - 144
  • [2] [Anonymous], 1979, AM REV RESPIR DIS, V119, P831
  • [3] BAHOUS J, 1985, B EUR PHYSIOPATH RES, V21, P25
  • [4] VALIDATION OF MORNING DIP OF PEAK EXPIRATORY FLOW AS AN INDICATOR OF THE SEVERITY OF NOCTURNAL ASTHMA
    BELLIA, V
    VISCONTI, A
    INSALACO, G
    CUTTITTA, G
    FERRARA, G
    BONSIGNORE, G
    [J]. CHEST, 1988, 94 (01) : 108 - 110
  • [5] BURROWS B, 1977, AM REV RESPIR DIS, V115, P751
  • [6] BURROWS B, 1980, AM REV RESPIR DIS, V122, P813
  • [7] COLOME S D, 1987, American Review of Respiratory Disease, V135, pA118
  • [8] DAVIES RJ, 1983, ASTHMA, P205
  • [9] DAVIES RJ, 1982, BRONCHIAL HYPERREACT, P187
  • [10] GREGG I, 1983, ASTHMA, P242