北京地区5～14岁健康儿童肺通气功能参数实测值占预计值百分比研究

Percentages of the measured value vs. the expected value of pulmonary function parameters in healthy children aged 5 -14 years in Beijing

目的 调查北京地区5-14岁健康儿童肺通气功能主要参数实测值占预计值百分比情况，为临床准确判读提供依据。方法 选择北京地区幼儿园和中小学5-14岁健康儿童400例（男198例，女202例），采用德国Jaeger肺功能仪进行流量容积-曲线测定。收集7项主要肺通气功能参数：呼气峰流量（PEF）、用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/FVC、用力呼出50%肺活量时的流量（FEF50）、用力呼出75%肺活量时的流量（FEF75）、最大呼气中期流量（MMEF）。以Jaeger肺功能仪中提供的Zapletal预计值公式（4-18岁）作为所调查儿童的预计值，计算其实测值占预计值的百分比。结果 5-12岁年龄组儿童男女身高、体质量相近，差异均无统计学意义（均P〉0.05）；13-〈14岁、14岁年龄组男童身高、体质量高于女童，差异均有统计学意义（t＝3.35、2.05、5.99、2.67，均P〈0.05）。不同年龄及性别儿童主要肺通气功能参数PEF、FVC、FEV1、FEV1/FVC实测值占预计值百分比均值分别波动于105.0%-114.7%、95.4%-106.8%、104.6%-115.4%、105.8%-112.6%。小气道功能参数FEF50、FEF75、MMEF实测值占预计值百分比分别波动于79.7%-103.7%、70.2%-110.5%、81.6%-114.7%。不同参数实测值占预计值百分比下限分别为PEF 85.0%，FVC 84.7%，FEV1 92.4%，FEV1/FVC 98.4%，FEF50 67.7%，FEF75 60.1%，MMEF 71.0%。结论 北京地区5-14岁健康儿童肺通气功能一些参数水平高于Zapletal提供的正常值，可将FEV1 92.4%，FEV1/FVC 98.4%，PEF 85.0%、FVC 84.7%，FEF50 67.7%，FEF75 60.1%，MMEF 71.0%作为实测值占预计值百分比的正常下限。

Objective To investigate the distribution of measured value and the expected value of spirometry parameters in healthy children aged 5 -14 years old in Beijing, and to provide evidence for clinical interpretation pre- cisely. Methods Four hundred healthy children （ 198 boys and 202 girls） aged 5 to 14 years from the kindergartens and the primary schools in Beijing were selected as subjects. All of the parameters were measured by using Jaeger Mas- terscreen spirometry machine（Germany）. Pulmonary function parameters including forced vital capacity （FVC）, forced expiatory volume in l second （FEVt ） , FEVt/FVC,peak expiratory flow（PEF） , forced expiratory flow at 50% of vital capacity （ FEF50 ） , forced expiratmy flow at 75 % of vital capacity （ FEF75 ）, and the maximal midexpiratory flow （MMEF） were collected for analysis. The expected values of the 7 parameters above were calculated according to Zapletal predic- tion equations（4 - 18 years old）. The measured value vs. the expected value was calculated. Results Children aged 5 to 12 years had similar height and weight between boys and girls, and the differences were not significant （all P 〉 0. 05 ） ;while boys were taller and heavier than gifts in 13 - 〈 14 years old group and 14 years old group, and the diffe- rences were significant（ t = 3.35,2. 05,5.99,2.67 ;all P 〈 0.05 ）. The mean measured value vs. the expected value of PEF,FVC,FEV1, FEV1/FVC of children in difthrent gender and age groups ranged between 105.0% - 114.7% , 95.4% - 106.8% , 104.6% - 115.4% and 105.8% - 112.6% ,respectively. The mean measured value vs. the expec- ted value of small airway function parameters FEFs0, FEF75, MMEF was as follows respectively：79.7% -103.7%, 70. 2% - 110.5% , and 81.6% - 114.7%. The low limit of normal（ LLN ） measured value vs. the expected value of the 7 puhnonary function parameters was as follows ：PEF 85.0% ,FVC 84.7% , FEVI 92.4% , FEVI/FVC 98.4% , FEFs0 67.7% ,FEF75 60.1% ,and MMEF 71.0%. Conclusions The pulmonary function parameters of the healthy children in Beijing are higher than those of the Zapletal prediction. The measured value vs. the expected value of FEV1 92.4% , FEVI/FVC 98.4% ,PEF 85.0% ,FVC 84.7% ,FEFs0 67.7% ,FEF75 60.1% ,and MMEF 71.0% can be used as LLN in 5 - 14 years old children.