贵阳地区健康儿童肺功能实测值占预计值百分比研究

A study on the percentages of measured value in the expected value of pulmonary function parameters in healthy children in Guiyang

目的调查贵阳地区5~13岁健康儿童肺通气功能部分主要参数的实测值占预计值百分比情况。方法随机选取贵阳市5~13岁健康儿童596例(男302例、女294例),使用德国耶格肺功能仪测定小气道功能的指标用力呼出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),大气道通气功能指标,呼气峰流量(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、一秒率(FEV1/FVC),小气道功能指标,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);使用Zapletal预计值公式(4~13岁)作为预计值,计算各指标实测值占预计值的百分比。结果肺功能FVC实测值占预计值百分比在12~13岁年龄组女性儿童高于男性儿童、差异有统计学意义(P<0.05),其余肺功能指标在不同性别儿童比较、差异无统计学意义(P>0.05);各肺通气功能指标实测值占预计值百分比的下限值分别为PEF 73.47%、FVC 81.30%、FEV187.11%、FEV1/FVC 98.14%、FEF5066.86%、FEF7562.73%、MMEF 68.03%,其中FEV1、FEV1/FVC、FVC高于指南及共识(80%),PEF、FEF75低于指南及共识(80%,65%),FEF50、MMEF与指南及共识接近。结论贵阳地区健康儿童部分肺通气功能参数水平高于ATS/ERS指南及我国儿童肺功能共识所提供的正常值。

Objective To investigate the actual measured values of pulmonary ventilation function in healthy children aged 5-13 in Guiyang area as a percentage of the predicted value so as to provide a basis for clinical interpretation.Methods Five hundred and ninety-six healthy children aged 5-13(302 males and 294 females)in Guiyang were randomly selected,and,by using German Yage spirometry(Master Screen Paed+IOS+APS),the following main pulmonary ventilation function parameters were measured and collected:peak expiratory flow(PEF),forced vital capacity(FVC),forced expiratory volume in one second(FEV1),forced expired volume in one second/forced vital capacity(FEV1/FVC),forced expiratory flow at 50%of FVC exhaled(FEF50),forced expiratory flow at 75%of FVC exhaled(FEF75),and maximal mid-expiratory flow(MMEF).The Zapletal predicted value formula(aged 4-13)was used as the predicted value to calculate the percentage of the measured value of each indicator to the predicted value.Result The percentages of measured value in the expected value of FVC in female children were higher than those in male ones in the age group of 12-13,and the difference was statistically significant(P<0.05).There were no significant differences in other parameters between genders.The lower limit values of the percentage of actual measured value in the expected value of the pulmonary function parameters were as follows:PEF(73.47%),FVC(81.30%),FEV1(87.11%),FEV1/FVC(98.14%),FEF50(66.86%),FEF75(62.73%),MMEF(68.03%),among which FEV1,FEV1/FVC,and FVC were higher than the guidelines and consensus(80%),PEF and FEF75 were lower than the guidelines and consensus(80%,65%),and the FEF50 and MMEF were close to them.Conclusion Some parameters of pulmonary ventilation function of healthy children in Guiyang area are higher than the normal values provided by ATS/ERS guidelines and China's consensus on pulmonary function of children.