尘肺患者心肺功能运动试验与静态肺功能相关性和一致性分析

Analysis of correlation for pneumoconiosis between cardiopulmonary exercise test and resting pulmonary function

目的探讨静态肺功能与心肺功能运动试验指标间的相互关系,为心肺功能运动试验应用于尘肺伤残评定提供客观依据。方法调查对象219人,其中I期煤工尘肺患者64例,正常对照155名,所有对象进行心肺功能运动试验和静态肺功能测定;测定结果进行相关分析、一致性分析和多元回归分析。结果尘肺患者单项静态肺功能指标中,控制年龄、身高和体重后,仅用力肺活量(FVC)指标与最大摄氧量(VO2max)有相关性(r=0.285),静态肺功能6项指标对VO2max变化的贡献率为25.6%。VO2max与静态肺功能各指标间判定肺损伤的一致性为0.065～0.255,而VE/VCO2AT和VE/VCO2max与静态肺功能各指标间判定肺损伤的一致性为0.158～0.329。结论运动试验与静态肺功能判定肺损伤相关性、一致程度和关联程度较低,在相同程度肺损伤评定上有较大差异。静态肺功能不能准确评定体力能力的大小和丢失程度。

Objective To explore relationship between cardiopulmonary exercise test （CPET） and resting pulmonary function test （resting PFT） ,in order to provide a scientific basis for applying CPET for assessment of impairment secondary to pneumoconiosis. Methods Two hundred and nineteen subjects, divided into two groups, （64 cases of patients with pneumoconiosis, 155 cases of control subjects unexposed to dust） were determined with CPET and resting PFT. Correlation analysis and consistence analysis and regression analysis was performed. Result in the pneumoconiosis group,after age, height and weight controlled, partial correlation analysis showed that only forced vital capacity （FVC） and maximal oxygen uptake （VO2max） showed correlation, the coefficient of partial correlation being 0.285. The indices of other resting PFT correlated not significantly with VO2max,When using 6 terms resting PFT as independent variable and VO2max as dependent variable, the combination of 6 terms of indices of resting PFT could account for the 25,6% of the variance of VO2max, The consistence coefficient in judging pulmonary impairment between resting PFT and VO2max was 0.065-0.255. The consistence coefficient in judging pulmonary impairment between resting PFT and ventilation equivalent for CO2 （VE/VCO2AT,VE/VCO2max）was 0.158-0.329. Conclusion The degree of correlation, consistence and association between CPET and resting PFT is weak.There is significant difference in judging pulmonary impairment for same degree pulmonary impairment. The resting PFT cannot precisely predict maximal physical capacity.