上海地区健康中老年人肺功能特点分析

The characteristics of pulmonary function in healthy middle-aged and elderly people in Shanghai

目的 分析上海地区中老年人群的肺功能参数,探讨其变化规律. 方法 选取2009年6月至2011年9月期间肺功能测定结果正常且不吸烟的健康体检者,其中年龄超过44岁者298例,分为老年前期组（45～59岁）、低龄老年组（60～69岁）和中高龄老年组（≥70岁）;19～44岁的227例作为青年组.收集13项肺功能参数：肺活量、用力肺活量（FVC）、第一秒用力呼气容积（FEV1）、第一秒率（FEV1/FVC）、功能残气量（FRC）、峰流量、用力肺容积25％时的最大呼气流速（FEF25）、用力肺容积50％时的最大呼气流速（FEF50）、肺总量、残气容积、残气容积/肺总量、肺一氧化碳弥散量（DLCO）和每升肺泡容积的一氧化碳弥散量（KCO）. 结果 与青年人比较,中老年人肺活量、FVC、FEV1、峰流量、肺总量,DLCO和KCO皆下降;残气容积、残气容积/肺总量皆升高[男性组（1.9±0.4）L比（1.6±0.3）L、（34.7±4.9）％比（26.4±4.3）％,P＜0.01;女性组（1.5±0.3）L比（1.3±0.3）L、（36.1±5.3）％比（30.3±5.5）％,P＜0.01].随着年龄的增长,残气容积呈进一步升高趋势,但差异无统计学意义（P＞0.05）,FRC基本无变化（P＞0.05）.中老年人FEV1/FVC较青年人降低[男性组（80.7±4.3）％比（84.2±5.6）％,P＜0.01;女性组（82.5±5.5）％比（86.4±4.8）％,P＜0.01],但中老年人不同年龄组间差异无统计学意义（P＞0.05）,其中年龄≥70岁的男性FEV1/FVC为（80.2±4.5）％,女性为（81.8±5.6）％. 结论 中老年人肺通气功能和弥散功能均随着年龄的增大而逐渐下降,残气量呈缓慢的升高趋势,但FRC基本稳定,FEV1/FVC的下降趋势明显减缓.

Objective To observe the changes of pulmonary function parameters in healthy middle-aged and elderly people in Shanghai.Methods A total of 298 subjects aged 45 years and over with normal pulmonary function and no smoking history were selected among subjects who underwent routine physical examination from Jun 2009 to Sep 2011.The subjects were divided into three groups：45-59 years,60-69 years,and ≥70 years.The tested pulmonary function included 13 parameters：vital capacity （VC）,residual volume （RV）,functional residual capacity （FRC）,total lung capacity （TLC）,RV/TLC,forced vital capacity （FVC）,forced expiratory volume in one second （FEV1）,FEV1/FVC,peak expiratory flow （PEF）,forced expiratory flow at 25 % of FVC exhaled （FEF25）,forced expiratory flow at 50% of FVC exhaled （FEF50）,diffusion capacity of the lung for carbon monoxide （DLCO）,and specific diffusion capacity of CO （KCO）.Results Compared with the young adults,7 pulmonary function parameters including VC,FVC,FEV1,PEF,TLC,DLCO and KCO were declined significantly in healthy middle aged and elderly people Compared with the young adults,pulmonary function parameters including RV and RV/TLC were increased [male （1.9 ±0.4）Lvs.（1.6±0.3）L,（34.7±4.9）% vs.（26.4±4.3）%,P〈0.01;female （1.5±0.3）L vs.（1.3±0.3）L,（36.1±5.3）% vs.（30.3±5.5）%,P〈0.01].Although RVincreased with aging in middle-aged and elderly people,but there was no statistical significance （P〉0.05）.FRC didn＆#39;t change obviously.FEV1/FVC was lower in old people than in young people[male （80.7±4.3）% vs.（84.2±5.6）%,P 〈0.01;female （82.5± 5.5） % vs.（86.4±4.8）%,P〈0.01],but the difference between 3 groups of middle-aged and the elderly was not significant.The FEV1/FVC of men and women aged 70 and more were （80.2±4.5）% and （81.8±5.6）%,respectively.Conclusions Both ventilation function and diffusion function of healthy elderly people are decreased with ageing,RV is increased and FRC is steady,and the declining tendency of FEV1/FVC obviously slows down with aging in middle aged and elderly people.