中国澳门地区健康成人脉冲振荡肺功能测定及预计值方程式探讨

Investigations of impulse oscillation technique and predictive equations in Macao healthy adults

目的探讨中国澳门地区健康成人脉冲振荡(impulse oscillometry system,IOS)肺功能特点,建立适合中国澳门地区健康成人的IOS预计值方程式。方法随机选取2011—2012年无吸烟史的中国澳门地区中国籍健康成人362例。采用德国Jaeger公司的Master Screen脉冲振荡肺功能测定仪进行检测,指标包括潮气量(VT)、呼吸总阻抗(Z5),5 Hz及20 Hz时呼吸阻力(R5、R20)和呼吸电抗(X5、X20);响应频率(RF)等,将所得的实测值分别与年龄(A,岁)、身高(H,cm)、体重(W,kg)、相对体重(CW)及性别行相关分析,同时进行多元逐步线性回归分析,得出预计值方程式;并与其他预计值方程式进行对比。结果上述气道阻力指标在各年龄组间差异无统计学意义;男女不同性别组间有统计学意义;气道阻力各主要指标预计值方程式分别为:男:Z5=1.380-0.007×H+0.002×W;R5=1.346+0.002×W-0.007×H;R20=0.972-0.004×H;X5=-0.434+0.002×H;X20=-0.037-0.0004×A+0.001×H;RF=25.81+0.033×A-0.099×H。女:Z5=0.802+0.002×A-0.004×H+0.122×CW;R5=0.227+0.001×A+0.308×CW-0.003×W;R20=0.8 7 5-0.0 0 3×H;X 5=-0.4 2 3+0.0 0 2×H+0.0 0 0 1×A;X 2 0=0.1 6 6+0.0 0 0 1×A-0.0 4 4×C W;RF=3.69+0.086×A+9.493×CW-0.08×W。结论建立了适合中国澳门地区人群的IOS各主要指标的预计值方程式,建议推广应用。

Objective To characterize the impulse oscillation technique in Macao healthy adults and to establish the predictive equations that suit this population. Methods A survey was conducted on 362 healthy Macao adults（179 males, 183 females） aged 18 to 78 years from January 2011 to December 2012. Respiratory impedance（Z5）, respiratory resistance（Rrs） and reactance（Xrs） at 5 Hz, 20 Hz resonant frequency（RF） were measured with the Jaeger Masterscreen IOS instrument.Measurements were carried out during spontaneous breathing and met the recommendations made by European Respiratory Society. Stepwise multiple regressions and linear regressions were carried out with SPSS 17.0 for windows statistical software to identify the best equations of IOS parameters using standing height（H）, weight（W）, age（A） and gender as potential determinants. Results Macao predictive normal equations were generated and compared with the current published equations. There were no statistical significances in the IOS parameters among different age groups, but there were statistical significances between groups with different genders. The equations were as follows： for males： Z5=1.380-0.007×H＋0.002×W; R5=1.346＋0.002×W-0.007×H; R20=0.972-0.004×H; X5=-0.434＋0.002×H; X20=-0.037-0.0004×A＋0.001×H; RF=25.81＋0.033×A-0.099×H; and for females：Z5=0.802＋0.002×A-0.004×H＋0.122×CW; R5=0.227＋0.001×A＋0.308×CW-0.003×W; R20=0.875-0.003×H; X5=-0.423＋0.002×H＋0.0001×A; X20=0.166＋0.0001× A-0.044×CW; RF=3.69＋0.086×A＋9.493×CW-0.08×W. Conclusion The predictive equations that suit Macao healthy adults have been produced for the IOS, and applications should be recommended.