成都地区549名健康儿童脉冲振荡肺功能测定

Determination of the lung function by impulse oscillometry in 549 healthy children in Chengdu area

目的确定成都地区儿童脉冲振荡(IOS)肺功能测定正常值。方法对549例4～14岁健康儿童(男292例,女257例),采用德国 Jaeger 公司生产的 Master Screen IOS 测定仪测定呼吸总阻抗(Zrs)、不同振荡频率下的黏性阻力(Rrs)、弹性阻力(Xrs)等指标,对各实测指标进行逐步线性多元回归,建立预计方程,同时用实测数据与试验所得方程式、Lechtenboerger 方程式和广州地区预计方程式进行配对比较。结果总阻抗、气道阻力与儿童身高、年龄呈负相关。Zrs(男)=-0.756+189.586/身高,r=-0.782,P<0.001;Zrs(女)=-0.497+152.468/身高,r=-0.726,P<0.001。Rrs 有相同趋势;而 Xrs 随身高的增加而增加,与身高呈正相关。脉冲振荡的多项参数与身高的关系最为密切,年龄次之,建立了 IOS 主要指标的多元回归方程式,各实测值与所得预计方程式的相关系数均大于 Lechtenboerger 方程式的相关系数;而与广州地区预计方程式差异无统计学意义。结论成都地区儿童脉冲振荡正常值参数与国外预计值参数有差异,该研究所得预计方程式更适合本地区儿童。建议脉冲振荡肺功能应尽量采用相应人群预计值。

Objective Impulse oscillometry （IOS） is a new method for determination of breathing mechanics, which features convenient operation, good repeatability and wider range analysis. As there is no standardized normal value in China at present, this study will provide a normal value of lung function determination by impulse oscillometry for children in Chengdu area. Method Totally 549 children were chosen at random from Chengdu area, with 292 boys and 257 girls who were 4 to 14 years old. The subjects were assigned into 10 age groups according to their chronological age with one year difference between every two adjacent groups. The respiratory total impedance （Zrs）, viscosity resistance （Rrs） and elastic resistance （Xrs） at various oscillation frequency were measured by the Master Screen IOS which was manufactured by German Jaeger Company. The measured data were treated with the linear stepwise multiple regression, and established the prediction equation. At the same time, paired comparison was carried out with the measured data and equation obtained from this study, Lechtenboerger equation and prediction equation obtained from Guangzhou area. Result The total impedance and airway resistance were negatively correlated with the children＇s height and age. Zrs （male） = -0. 756 ＋ 189. 586/height, r = -0. 782, P 〈 0. 001 ; Zrs （female） = - 0. 497 ＋ 152. 468/height, r = - 0. 726, P 〈 0. 001. Rrs became the same in trend; while Xrs were proportional to the height, e.g. the values increased as the height increased. The difference of the airway resistance （R5 -R20 ） was negatively correlated with the children＇s height： R5 -R20 （male） =0.601 -0.0034 × height, r = -0.677, P 〈0.001; R5 - R20 （female） =0.549 -0.0031 × height, r = -0. 658, P 〈 0.001. Among the relationships with many impulse oscillometry parameters, height ranked at first place; age at second. The multiple regression equation of IOS primary index was established. Both the measured data and the correlation coefficient of the study obtained equation were greater than the coefficient correlation of the Lechtenboerger equation, but had no significant difference compared with that of prediction equation in Guangzhou area. Conclusion The normal value in impulse oscillometry in children in Chengdu area is different from the predicted parameters in other countries. The equation obtained from this study seems to be more suitable for the children in its local area. It is recommended to apply the predicted value from the corresponding population in the determination of the lung function by impulse oscillometry.