重庆地区3~12岁儿童肺通气功能预计方程式的初步建立

Predictive modeling of reference equations for pulmonary ventilation function parameters of children aged 3-12 years in Chongqing

目的建立学龄前期及小学阶段学龄期儿童的肺通气功能参数预计方程式。方法采用德国JAEGER公司MasterScreen Pead肺功能仪,于2017年4月至2018年9月对重庆地区主城两所幼儿园及小学的458名3~12岁儿童进行肺通气功能测定。采用SAS9.4统计软件包,通过单因素线性回归模型分析各已知及潜在的影响因素与各肺功能参数的相关性,以各肺功能指标实测值为因变量,以性别、年龄、身高、体重为自变量,通过多元逐步回归建立线性回归方程。将构建的方程式与文献中相应年龄段的肺功能预计方程式进行比较,采用相对预测误差平均值评价各公式的适用性。结果对于学龄前期儿童,肺功能各指标[剩余25%肺活量时的用力呼气流量(MEF25)除外]均与月龄、身高、体重相关,性别与用力肺活量(FVC)、第0.5秒用力呼气容积(FEV0.5)、第1秒用力呼气容积(FEV1)、呼气峰流速(PEF)、MEF75、MEF50和最大通气量(MVV)相关。对于学龄期儿童,年龄、身高、体重与除呼气中段流速(MMEF)外的各肺功能指标均有显著相关性,性别与FVC、FEV1、FEV0.5/FVC、MEF50、MVV显著相关。预计公式模型比较后显示,该次构建的模型对该研究群体有较好的适用性。结论年龄、身高和体重为影响学龄前期和学龄期儿童肺通气功能参数的主要变量,性别对学龄前期儿童肺功能参数的影响多于学龄期儿童,应根据不同年龄段建立各项肺通气功能指标的预计公式。该模型的构建可为3~12岁儿童肺通气功能相关参数的预测提供帮助。

Objective To establish predictive modeling of reference equations for pulmonary ventilation function parameters of pre-school children and primary school-age children.Methods The pulmonary function test(PFT)of 458 children aged 3-12 years from Chongqing were measured using JAEGER MasterScreen Pead system with standardized protocols.All statistical analyses were performed using SAS Statistics version 9.4.Univariate linear regression was used to analyze the influence of the known or potential influencing factors on each PFT parameters,then reference equations adjusted for gender,age,length and weight were built using multiple linear regression model.Comparison between our estimates and those published reference equations was done,the mean of relative prediction error(RPE%)the applicatility was used to evaluate of the equations.Results Age,height and weight were correlated with each PFT parameters(excepted MEF25)in pre-school children,and gender was correlated with FVC、FEV0.5、FEV1、PEF、MEF50、MEF75 and MVV.In school-age children,age,height and weight were correlated with each PFT parameters excepted MMEF,gender was correlated with FVC,FEV1,FEV0.5/FVC,MEF50 and MVV.Comparisons between various predictive equations showed that the current equations derived from our raw data were applicable to our population.Conclusion Age,height and weight are the main variables affecting most parameters of PFT for preschool and school-age children.The influence of gender on pre-school children is greater than on school age children.Establishment of predicted reference equations of PFT parameters should be based on different age groups.The current equations are applicable in children aged 3-12 years for the prediction of pulmonary ventilation function parameters.