title: [Comparison of lung volume response with airflow response to bronchodilator in patients with chronic obstructive pulmonary disease].
abstract: OBJECTIVE
  the reversibility of chronic obstructive pulmonary disease (COPD) is evaluated mainly by FEV(1) after bronchodilators. However, lung volumes also change significantly in COPD, but few studies addressed the characteristics of the changes in post bronchodilator airflow and lung volume in patients with COPD. This study was carried out to evaluate the difference of FEV(1) response and forced vital capacity (FVC) response to bronchodilators in patients with COPD as well as the impact of severity of COPD on the flow and volume reversibility.
  
  
  METHODS
  465 patients with COPD (male 426, female 39), aged 67.1 +/- 8.3 (42 approximately 86) yrs were enrolled from Jan. 2006 to Aug. 2008. The severity of COPD was graded according to the GOLD criteria. The change and rate of change of FVC and FEV(1) 20 minutes after inhalation of salbutamol 400 microg via spacer were measured and compared. Positive response to the bronchodilator was determined as FEV(1) or FVC increased 12% as well as 200 ml or above. The impacts of severity on flow and volume response were also studied.
  
  
  RESULTS
  post-bronchodilator FEV(1) increased 117 ml with a 13.2% improvement on average compared with baseline. Post-bronchodilator FVC increased 258 ml and improved by 14.0% on average. The rate of positive reversibility in FEV(1) and FVC was 18.7% (87/465) and 44.1% (205/465), respectively. The improvement of FEV(1) decreased as a function of the severity of COPD. In contrast, the improvement of FVC was increased in those with more severe disease.
  
  
  CONCLUSIONS
  the improvement of lung volume is more significant and maybe more important than airflow response in patients with COPD, especially in those with severe disease. In addition to FEV(1), the reversibility of COPD should also be evaluated by FVC.
authors.affiliation: First Clinical Department, First TeachingCollege of Guangzhou Medical University, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Fu-Qiang
authors.initials: FQ
authors.lastname: Zhang
authors.forename: Jin-Ping
authors.initials: JP
authors.lastname: Zheng
authors.forename: Jia-Hong
authors.initials: JH
authors.lastname: Wang
authors.forename: Wei-Bo
authors.initials: WB
authors.lastname: Lu
authors.forename: Rui-Xing
authors.initials: RX
authors.lastname: Wu
authors.forename: Xiao-Shan
authors.initials: XS
authors.lastname: Li
authors.forename: Qing-Zhang
authors.initials: QZ
authors.lastname: Xian
authors.forename: Yi
authors.initials: Y
authors.lastname: Gao
authors.forename: Mei
authors.initials: M
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000503:physiopathology*; D005260:Female; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012129:Respiratory Function Tests; D013147:Spirometry