新型冠状病毒肺炎患者出院半年后肺通气功能及影响因素

Assessment of pulmonary ventilation function and influencing factors in COVID-19 patients six months after discharge from hospital

目的:评估新型冠状病毒肺炎(COVID-19)患者治愈出院半年后的肺通气功能水平,并分析相关影响因素,为采取针对性的健康促进措施提供科学依据。方法:2020年11月份在湖北省武汉市某区调查151例COVID-19康复期个体,检测其肺通气功能指标[用力肺活量占预计值百分比(FVC%pred),第1秒用力呼气容积占预计值百分比(FEV_(1)%pred),第1秒用力呼气容积与用力肺活量的比值占预计值百分比(FEV_(1)/FVC%),用力呼出气量为50%肺活量时的呼气流量占预计值百分比(FEF_(50%)%pred),用力呼出气量为75%肺活量时的呼气流量占预计值百分比(FEF_(75%)%pred),用力呼出气量为25%~75%肺活量间的平均呼气流量占预计值百分比(MMEF%pred)];并作肺通气功能影响因素的相关性分析。结果:151例调查对象入院诊断为轻型者64例,普通型者87例。普通型组男女平均年龄均大于轻型组,差异均有统计学意义(Ρ<0.05)。调查对象肺通气功能相关指标平均值在正常范围内;其中男性患者FVC%pred及女性患者FVC%pred、FEV_(1)%pred值均为轻型组优于普通型组(Ρ<0.05)。尚有部分患者存在轻度肺通气功能异常;其中轻型组11例,以阻塞性通气功能障碍为主;普通型组46例,以限制性通气功能障碍为主;两组间肺通气功能异常的差异性有统计学意义(Ρ<0.001)。多因素Logistic回归分析结果显示,女性[OR=3.012, 95%CI(1.249, 7.264)]、既往存在慢性疾病史[OR=2.739, 95%CI(1.186,6.326)]及入院诊断为普通型患者[OR=6.365, 95%CI(2.730,14.840)]为出院后仍然存在肺通气功能异常的危险因素。结论:轻型和普通型患者出院半年后肺通气功能恢复良好。女性人群和既往有慢性疾病者,在出院后的康复期要有更针对性的健康指导。

Objective: To assess the level of pulmonary ventilation function in patients with COVID-19 after six months post-discharge and analyze the relevant influencing factors. Methods: In November2020, patients with COVID-19 were investigated in a district of Wuhan City, Hubei Province. Their pulmonary ventilation function indicators were measured, including forced vital capacity of percent predicted(FVC% pred), forced expiratory volume in one second of percent predicted(FEV_(1)%pred),FEV_(1)/FVC ratio(FEV_(1)/FVC%),forced expiratory flow at 50% of percent predicted(FEF_(50%)pred),forced expiratory flow at 75% of percent predicted(FEF_(75%)pred), mean forced expiratory flow between 25% and 75% of percent predicted(MMEF% pred). The related factors affecting pulmonary ventilation function were analyzed. Results: A total of 151 discharged cases were recruited, which included 64 cases of mild illness, 87 cases of moderate illness. The average age of both men and women in the mild group was significantly higher than that in the moderate group(P < 0.05). The mean values of the lung ventilation function indexes were all within the normal range. The FVC% pred in both male and female and FEV_(1)%pred in female were better in the mild group than that in the moderate group(P < 0.05). Some patients had mild abnormal pulmonary ventilation function and 11 cases in the mild group, 46 cases in the moderate group. Multi-factor logistic regression analysis showed that women [OR=3. 012, 95%CI(1. 249,7. 264)], the presence of a previous history of chronic disease [OR=2. 739, 95%CI(1. 186, 6. 326)], and cases of moderate illness [OR=6. 365, 95%CI(2. 730, 14. 840)] were the risk factors for abnormal pulmonary ventilation function after discharge.Conclusion: Half a year after discharge, the pulmonary ventilation function of both mild and moderate group patients recovered well. Women and those with chronic disease in the past should have more targeted health guidance during the post-discharge recovery period.