高海拔对学龄期儿童肺功能的影响

A study of the respiratory function on school-age children from high altitude

目的研究高海拔对学龄期儿童肺功能的影响。方法在当地对生活在海拔3000 m(合作市)、1500 m(兰州市)和海平面(北京市)地区的6~12周岁323例、356例和305例健康学龄期儿童进行现况研究,进行肺通气功能指标用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV_(1)/FVC、最大呼气流量(PEF)和每分钟最大通气量(MVV)的检查,对同年龄段同性别组分别进行单因素方差分析。结果对于不同海拔高度生活的男童,FVC在6~12岁各年龄段差异均有统计学意义(P值均<0.05),FEV1在除7岁以外的6~12岁各年龄段差异均有统计学意义(P值均<0.05),FEV_(1)/FVC在11岁和12岁年龄段差异均有统计学意义(P值均<0.05),PEF在8~12岁年龄段差异均有统计学意义(P值均<0.05),MVV在7岁、11岁和12岁差异均有统计学意义(P值均<0.05)。对于不同海拔高度生活的女童,FVC、FEV_(1)在6~12岁各年龄段差异均有统计学意义(P值均<0.05),FEV_(1)/FVC在6岁和12岁年龄段差异均有统计学意义(P值均<0.05),PEF在8岁、9岁、11岁和12岁年龄段差异均有统计学意义(P值均<0.05),MVV在6岁、7岁和12岁差异均有统计学意义(P值均<0.05)。结论高海拔对学龄期儿童肺功能有影响,且可能有时间累积效应,高海拔地区儿童肺功能解读不能完全以海平面地区为标准。较高的3000 m海拔,降低单次肺通气量和肺储备量,较高的海拔与肺功能的下降可能存在一定的线性关系。适度的1500 m海拔,在相对较短的时间段内可能提高肺通气量和肺储备量,在相对较长的时间段内可能反而降低通气量。高海拔可能降低学龄期儿童小气道通气功能。指标中高海拔影响最小的FEV_(1)/FVC,可能较其他指标可信度更高。

Objective To research the effects of high altitude on the respiratory function for school-age children.Methods It was tested in the locality that forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),FEV_(1)/FVC,peak expiratory flow(PEF),and maximum ventilator volume(MVV)of the healthy school-age children from 6 to 12 years old.There were 323,356 and 305 school-age children at altitude 3000 m(Hezuo),1500 m(Lanzhou)and sea level(Beijing)to be studied with method of existing circumstances research.And then results were analyzed with one-way analysis of variance for the same age and sex group respectively.Results For male school-age children at different altitude,FVC has statistical difference from age 6 to 12(all P<0.05),FEV_(1) has statistical difference except age 7 from age 6 to 12(all P<0.05),FEV_(1)/FVC has statistical difference at the age of 11 and 12(both P<0.05),PEF has statistical difference from age 8 to 12,MVV has statistical difference at the age of 7,11 and 12(all P<0.05).For female school-age children at different altitude,FVC and FEV_(1) have statistical difference from age 6 to 12(all P<0.05),FEV_(1)/FVC has statistical difference at the age of 6 and 12(both P<0.05),PEF has statistical difference except age 10 from age 8 to 12,MVV has statistical difference at the age of 6,7 and 12(all P<0.05).Conclusions High altitude has effects on respiratory function tests for school-age children,which effects perhaps have time accumulation influence,the standard of respiratory function at sea level isn′t suitable for highland.Pulmonary ventilation volume per time and functional reserve are lower at 3000 m altitude than at sea level,maybe this height-effects has positive correlation at higher altitude.Pulmonary ventilation volume and functional reserve are higher at moderate 1500 m altitude than at sea level for a short period,but it is contrary for a longer period.High altitude possibly has a negative effect on ventilation of the pulmonary small airway.FEV_(1)/FVC is probably more credible than others on account of less variation.