天津地区健康成年人鼻通气功能的客观评估

Objective evaluation of nasal ventilation function in healthy adults in Tianjin area

目的:建立天津地区健康成年人鼻声反射、鼻阻力、鼻呼吸量参数的参考值范围,分析年龄、性别及侧别对其的影响,探讨各测量值间的相关性,为天津地区健康成年人鼻通气功能检查提供诊断数据。方法:利用A1鼻声反射仪测量天津地区466例健康成年人的鼻腔最小截面积(MCA)、鼻腔最小截面积距前鼻孔距离(DCAN)、鼻腔0～5cm容积(V5)、2～5cm容积(V2～5);利用NR6鼻阻力仪测量受试者经鼻压差为150Pa、75Pa下及用broms测量的鼻腔单侧吸气阻力(IR)、呼气阻力(ER);通过计算得出双侧吸气总阻力(TIR)、双侧鼻腔呼气总阻力(TER)及左右鼻腔阻力差异比(Rlr);利用NV1鼻呼吸量仪测量单侧鼻腔吸气量、呼气量,通过计算得出鼻呼吸量差异比(NPR,包括吸气量差异比NRPi和呼气量差异比NRPe)。实际测量下鼻甲前端至前鼻孔的距离(L),并与DCAN比较。对3种检查不同指标做相关性分析。结果:鼻声反射参数:MCA男为(0.45±0.16)cm2,女为(0.44±0.16)cm2;V2～5男为(3.52±1.38)cm3,女为(3.36±1.22)cm3;V5男为(5.10±1.47)cm3,女为(4.86±1.12)cm3;DCAN存在2个位置,男分别为(2.22±0.39)cm、(0.53±0.62)cm,女分别为(2.10±0.37)cm、(0.67±0.15)cm;L男为(2.48±0.36)cm,女为(2.15±0.26)cm。MCA、V5、V2～5在性别、侧别、年龄上均差异无统计学意义,DCAN在年龄、侧别上无差异,男女间差异有统计学意义。鼻阻力参数:经鼻压差在150Pa、75Pa、broms测量下IR、ER、TIR、TER在侧别及年龄上均差异无统计学意义,男女差异有统计学意义。鼻呼吸量参数:IC男为(2.06±1.10)L/20s,女为(1.37±0.34)L/20s;EC男为(2.15±1.23)L/20s,女为(1.39±0.58)L/20s;NPRi、NPRe分别为0.11[0.05,0.23]、0.11[0.05,0.19]。IC、EC在侧别上无差异;在性别上有差异。NPR在性别、年龄上无差异。MCA与IR、ER呈负相关(r=-0.21、-0.22,均P<0.05),MCA与IC、EC间均存在正相关(r=0.12、0.17,均P<0.05),IR与IC、ER与EC间呈负相关(r=-0.10、-0.10,均P<0.05),Rlr与NPRi、NPRe均呈负相关(r=-0.19、-0.18,均P<0.05)。结论:鼻声反射、鼻阻力、鼻呼吸量参数可以作为评估鼻通气功能的参考指标,三者结合参考价值更大。

Objective：To establish reference values of acoustic rhinometry,rhinomanometry and rhinospirometer in healthy adults in Tianjin area,analyze the effects of age,sex and side on the value,investigate the correlation of the measure values,offer the diagnosis date for test nasal ventilation function in Tianjin area.Method：Four hundred and sixty-six healthy adults in Tianjin area were tested.A1 acoustic rhinometry was used to measure the minimum cross-sectional area（MCA）,distance of the minimal cross-sectional area to the nostril（DCAN）and the nasal volume from 0-5 cm,2-5 cm（V_5,V_ 2～5）;At 150 Pa,75 Pa and broms,NR6 Rhinomanometry was used to measure unilateral nasal inspiratory resistance（IR）and expiratory resistance（ER）,bilateral nasal inspiratory and expiratory resistance（TIR and TER）,and differences of the bilateral nasal resistance can be calculated;NV1 Rhinospirometer was used to mesure unilateral inspiratory capacity（IC）and expiration capacity（EC）,and the nasal partitioning ratio（NPR）can be calculated.Practical measure the distance of nostril to ahead of the inferior turbinate and compare with DCAN.Make the correlational analysis on different index of three exam.Result：Reference values of acoustic rhinometry：MCA was（0.45±0.16）cm^2 for male,（0.44±0.16）cm^2 fro female;V_ 2-5 was（3.52± 1.38）cm^3 for male,（3.36±1.22）cm^3 for female,V_5 was（5.10±1.47）cm^3 for male,（4.86±1.12）cm^3 for female;DCAN have two distince,（2.22±0.398、0.53±0.625）cm was for male,（2.10±0.37、0.67±0.15）cm was for female;No significant gender,side and age differences were shown in MCA,V_5,V_ 2-5.Significant gender differences were shown in DCAN but no side and age differences.Reference values of rhinomanometry：Significant gender but no side and age differences were shown in IR,ER,TIR,TER.Reference values of rhinospirometer：IC was（2.06±1.10）L/20 s for male,（1.37±0.34）L/20 s for female,EC was（2.15±1.23）L/20 s for male,（1.39±0.58）L/20 s for female.NPRi was 0.11[0.05,0.23],NPRe was 0.11[0.05,0.19].Significant gender but no side and age differences were shown in IC and EC.No gender and age differences were shown in NPRi and NPRe.There was significant correlation found between MCA and IR/ER/IC/EC,IR and IC,ER and EC,Rlr and NPRi/NPRe.Conclusion：Acoustic rhinometry,rhinomanometry and rhinospirometer can be useful reference values to evaluate nasal ventilation function,more value will be found if use the three together.