Preporuka GOLD je da definitivna dijagnoza HOBP ne može biti postavljena bez testova plućne funkcije (spirometrije): forsiranog ekspiratornog volumena u prvoj sekundi (FEV1) i odnosa (FEV1/FVC) . I pored nesumnjive praktičnosti GOLD kriterijuma neophodno je finije definisanje donje granične vrednosti za predložene spirometrijske parametre. Cilj rada je bio da se utvrdi da li su testovi plućne funkcije predloženi od strane GOLD (FEV1 i odnos FEV1/FVC) dovoljni za preciznu dijagnostiku i za procenu stadijuma (uz klinički pregled i MRC upitnik) HOBP kao i da pokušamo da utvrdimo koji su dodatni spirometrijski parametri pogodni za potvrdu dijagnoze u sumnjivim situacijama. Studijom je obuhvaćena 101 osoba sa potvrđenom dijagnozom HOBP kod kojih su spirometrijom mereni FEV1, FVC, FEV1/FVC, FEF50%FVC i FEF75%FVC. U GOLD II stadijumu bolesti bilo je 61 (60,4%); GOLD III 31 (30,7%) i u GOLD IV bilo je 9 ispitanika (8,9%). Kod 11 ispitanika (10,9%) vrednosti odnosa FEV1/FVC bile su iznad 0,7. Od 61 ispitanika sa GOLD II stadijumom HOBP kod 10 (16,4% ) ispitanika odnos FEV1/FVC je bio iznad 0,7. Jedan (3,2%) ispitanik sa GOLD III stadijumom je imao vrednosti odnosa FEV1/FVC iznad 0,7. Nije bilo slučaja sa normalnim vrednostima za FEF50%FVC i FEF75%FVC kod svih ispitanika. U situacijama kada imamo bilo kakvu nedoumicu u interpretaciji dva 'zlatna'kriterijuma za HOBp od strane GOLD (FEV1 i odnos FEV1/FVC) obavezno treba razmotriti i dodatne parametre plućne funkcije. Naša preporuka je da to budu vrednosti protoka vazduha u malim disajnim putevima (FEF75%FVC i FEF50%FVC).
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