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Abstract：
Pulmonary function tests (PFTs) are pivotal in diagnosing and managing a broad spectrum of respiratory disorders. These tests provide critical insights into lung health, guiding diagnoses, assessing disease severity, and shaping patient management strategies. This review addresses the complexities and nuances inherent in interpreting PFT data, particularly in light of recent updates from the European Respiratory Society (ERS) and American Thoracic Society (ATS). These updates have refined interpretive strategies, moving away from definitive diagnostic uses of spirometry to a more probabilistic approach that better accounts for individual variability through the use of Z-scores and lower limits of normal (LLNs). Significantly, this narrative review delves into the philosophical shift in spirometry interpretation, highlighting the transition from direct clinical diagnostics to a more nuanced evaluation geared towards determining the likelihood of disease. It critiques the reliance on fixed ratios and emphasizes the need for reference values that consider demographic variables such as age, sex, height, and ethnicity, in line with the latest Global Lung Function Initiative (GLI) equations. Despite these advances, challenges remain in ensuring uniformity across different predictive models and reference equations, which can affect the accuracy and consistency of interpretations. This paper proposes a streamlined three-step framework for interpreting PFTs, aiming to unify and simplify the process to enhance clarity and reliability across various medical specialties. This approach not only aids in accurate patient assessments but also mitigates the potential for misdiagnosis and ensures more effective patient management. By synthesizing contemporary guidelines and integrating robust physiological principles, this review fosters a standardized yet flexible approach to PFT interpretation that is both scientifically sound and practically feasible.
摘要：
肺功能测试（PFTs）在诊断和管理广泛的呼吸系统疾病中至关重要。这些测试提供了对肺部健康的重要见解，指导诊断，评估疾病严重程度，并制定患者管理策略。这篇综述解决了解释PFT数据所固有的复杂性和细微差别，特别是根据欧洲呼吸学会（ERS）和美国胸科学会（ATS）的最新消息。这些更新有完善的解释策略，从肺活量测定的明确诊断使用转向更概率的方法,该方法通过使用Z评分和正常下限(LLN)更好地解释个体差异.重要的是,这篇叙述性评论深入探讨了肺活量测定解释的哲学转变，强调了从直接临床诊断到更细致的评估的转变，旨在确定疾病的可能性。它批评了对固定比率的依赖，并强调需要考虑人口统计学变量的参考值，例如年龄，性别,高度,和种族,符合最新的全球肺功能倡议(GLI)方程。尽管取得了这些进展,在确保不同预测模型和参考方程的一致性方面仍然存在挑战，这会影响解释的准确性和一致性。本文提出了一个简化的三步框架来解释PFT，旨在统一和简化流程，以提高各个医学专业的清晰度和可靠性。这种方法不仅有助于准确的患者评估，还可以减轻误诊的可能性，并确保更有效的患者管理。通过综合当代指南和整合强大的生理原理，这项审查促进了一种标准化而灵活的PFT解释方法，该方法在科学上是合理的，实际上是可行的。
