Takaisin Tulosta

LLN (lower limit of normal)

Lisätietoa aiheesta
Käypä hoito -työryhmä Keuhkoahtaumatauti
21.11.2019

Määritelmä FEV1/FVC < 0,7 aiheuttaa viitearvoon perustuvaan LLN (lower limit of normal) -määritelmään verrattuna jonkin verran ylidiagnostiikkaa iäkkäillä «Kainu A, Timonen K, Lindqvist A ym. GOLD criteria ...»1, «Schermer TR, Smeele IJ, Thoonen BP ym. Current cli...»2, «Vollmer WM, Gíslason T, Burney P ym. Comparison of...»3 ja mahdollisesti naisilla «Jordan RE, Miller MR, Lam KB ym. Sex, susceptibili...»4 sekä alidiagnostiikkaa alle 45-vuotiailla «Vollmer WM, Gíslason T, Burney P ym. Comparison of...»3, mutta se on herkkä lääkärin kliinisesti varmistaman keuhkoahtaumataudin toteamisessa «Güder G, Brenner S, Angermann CE ym. "GOLD or lowe...»5, «Mohamed Hoesein FA, Zanen P, Sachs AP ym. Spiromet...»6, «Mohamed Hoesein FA, Zanen P, Lammers JW. Lower lim...»7. Määritelmän mukainen ahtauman aste on verrannollinen kuolleisuuteen «Mannino DM, Diaz-Guzman E. Interpreting lung funct...»8.

Kirjallisuutta

  1. Kainu A, Timonen K, Lindqvist A ym. GOLD criteria overestimate airflow limitation in one-third of cases in the general Finnish population. ERJ Open Res 2016;2: «PMID: 28053971»PubMed
  2. Schermer TR, Smeele IJ, Thoonen BP ym. Current clinical guideline definitions of airflow obstruction and COPD overdiagnosis in primary care. Eur Respir J 2008;32:945-52 «PMID: 18550607»PubMed
  3. Vollmer WM, Gíslason T, Burney P ym. Comparison of spirometry criteria for the diagnosis of COPD: results from the BOLD study. Eur Respir J 2009;34:588-97 «PMID: 19460786»PubMed
  4. Jordan RE, Miller MR, Lam KB ym. Sex, susceptibility to smoking and chronic obstructive pulmonary disease: the effect of different diagnostic criteria. Analysis of the Health Survey for England. Thorax 2012;67:600-5 «PMID: 22382600»PubMed
  5. Güder G, Brenner S, Angermann CE ym. "GOLD or lower limit of normal definition? A comparison with expert-based diagnosis of chronic obstructive pulmonary disease in a prospective cohort-study". Respir Res 2012;13:13 «PMID: 22309369»PubMed
  6. Mohamed Hoesein FA, Zanen P, Sachs AP ym. Spirometric thresholds for diagnosing COPD: 0.70 or LLN, pre- or post-dilator values? COPD 2012;9:338-43 «PMID: 22489910»PubMed
  7. Mohamed Hoesein FA, Zanen P, Lammers JW. Lower limit of normal or FEV1/FVC < 0.70 in diagnosing COPD: an evidence-based review. Respir Med 2011;105:907-15 «PMID: 21295958»PubMed
  8. Mannino DM, Diaz-Guzman E. Interpreting lung function data using 80% predicted and fixed thresholds identifies patients at increased risk of mortality. Chest 2012;141:73-80 «PMID: 21659434»PubMed