我国北方职业人群肺通气功能指标预计值及其影响因素

Predictive equations and analysis of influence factors of lung ventilation based on a large occupational population in North China

目的为开展职业人群肺通气功能测定提供依据。方法以人员比较稳定的5所大、中型企业的在岗及退休职工中劳动强度以中度、轻度为主的人员共5002人为受检者;采用日本Chest公司HI198肺功能仪,按照美国胸科协会(ATS)对肺功能测定和评价的建议,进行肺通气功能测试,3913人的测试结果用于建立预计值回归方程。结果正态性检验和频率分布曲线分析显示,所获数据符合或基本符合正态分布。单因素相关分析表明,年龄、身高分别与用力肺活量(FVC)、一秒用力呼气量(FEV1)、一秒用力呼气量/用力肺活量百分比[FEV1/FVC(%)]和最大呼气中期流速(MMF)的相关性有统计学意义(P<0.05)。单因素相关分析及多元逐步回归分析显示,FVC、FEV1、FEV1/FVC(%)、MMF受年龄、身高、体重影响较大,而受胸围变量(呼气胸围、吸气胸围、呼气胸围与吸气胸围之差)影响较小。综合分析仅将年龄、身高、体重3个变量引入预计值回归方程,经与引入多个变量的回归方程比较,差异无统计学意义(P>0.05)。所获预计值回归方程经原始资料、考核资料回代检验,符合率均大于90%,且原始资料与考核资料的肺通气功能指标,差异无统计学意义(P>0.05)。结论提出了适用于我国北方职业人群肺通气功能评价的非吸烟健康男性和女性、吸烟健康男性的FVC、FEV1、FEV1/FVC(%)、MMF肺通气功能指标的预计值公式建议。

Objective To establish suitable predictive equations of lung function for occupational population in North China. Methods A total of 5002 on the job or retired healthy adults from five enterprises in North China with category of mild or moderate work intensity underwent spirometry using a Chest HI-198 spirometer and the procedures recommended by the American Thoracic Society. Results The data of 3913 subjects were used. A normal distribution of our data was shown using the normality test and distribution curve. Univariate analysis showed that both age and height were significantly correlated with FVC, FEV1, FEV1/FVC（ % ） and MMF. Futher multiple linear stepwise regression analysis indicated that the levels of FVC, FEV1, FEV1/FVC（ % ） and MMF were highly influenced by age, height, and weight rather than chest circumference. Thus, only age, height, and weight were introduced into our regression equations. Data from the studied subjects and other source were utilised to examine the validity of the equations,and a high accordance rate（ 〉 90% ） was obtained. No significant difference（ P 〉 0.05） was found in the predictive values between the simplified equations and equations in which more variables were included. Conclusion The studied predictive equations for male non-smokers, female non-smokers, and male smokers were established based on data from a large occupational population. These equations should be more applicable for evaluating lung ventilatory function of occupational populations in North China.