重庆地区3~12岁健康儿童肺通气功能参数实测值与预计值的对比研究

A comparative study on the measured and predicted values of pulmonary ventilation function parameters in the healthy children aged 3-12 years old in Chongqing

目的探讨重庆地区3~12岁健康儿童肺通气功能参数实测值与Zapletal预计值的百分比(实/预%),为临床肺功能检查结果的合理判读提供参考依据。方法以Zapletal预计值公式的数值为预计值,回顾性分析重庆地区458名3~12岁儿童肺通气功能各参数的最佳实测值与Zapletal预计值的百分比(实/预%)情况,参数包括用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、第1秒用力呼气容积占肺活量比值(FEV_(1)/FVC)、呼气峰流速(PEF)、剩余75%肺活量时的用力呼气流量(MEF_(75))、剩余50%肺活量时的用力呼气流量(MEF_(50))、剩余25%肺活量时的用力呼气流量(MEF_(25))、呼气中段流速(MMEF)、最大通气量(MVV)。结果3~12岁儿童肺通气功能各参数实/预%的均值波动范围如下:FVC 96.11%~105.33%、FEV_(1)98.17%~116.78%、FEV_(1)/FVC 99.98%~110.14%、PEF 91.18%~108.42%、MEF_(75)91.88%~110.76%、MEF_(50)85.77%~107.66%、MEF_(25)68.00%~106.49%、MMEF 78.90%~114.00%、MVV 134.70%~180.78%。各参数实/预%的正常值下限(LLN)值如下:FVC 84.70%、FEV_(1)88.50%、FEV_(1)/FVC 96.00%、PEF 79.50%、MEF_(75)77.20%、MEF_(50)66.00%、MEF_(25)56.70%、MMEF 67.10%、MVV 108.80%。结论Zapletal预计值与重庆地区3~12岁健康儿童肺通气功能各参数水平存在差异,其在临床应用中有一定的局限性,应综合分析评价肺通气功能。

Objective To investigate the percentage(actual/predicted-%)between the measured versus predicted values of pulmonary ventilation function parameters and the predicted values of Zapletal in healthy children aged 3-12 years old in Chongqing,so as to provide a reference basis for the rational interpretation of the clinical pulmonary function test results.Methods Using the Zapletal predicted value formula as the predicted value,a retrospective analysis of the percentage of best measured versus predicted values(actual/predicted-%)for each parameter of pulmonary ventilation function in 458 children aged 3-12 years old in Chongqing was performed.The parameters included the forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),forced expiratory volume in one second ratio to forced vital capacity(FEV_(1)/FVC),peak tidal expiratory flow(PEF),forced expiratory flow at 75%remaining expiration(MEF_(75)),forced expiratory flow at 50%remaining expiration(MEF_(50)),forced expiratory flow at 25%remaining expiration(MEF_(25)),maxi-mum mid-expiratory flow(MMEF),maximal voluntary ventilation(MVV).Results The ranges of fluctuation of the mean values of the actual/predicted-%for each parameter of pulmonary ventilation function in children aged 3-12 years old were as follows:FVC 96.11%-105.33%,FEV_(1)98.17%-116.78%,FEV_(1)/FVC 99.98%-110.14%,PEF 91.18%-108.42%,MEF_(75)91.88%-110.76%,MEF_(50)85.77%-107.66%,MEF_(25)68.00%-106.49%,MMEF 78.90%-114.00%,MVV 134.70%-180.78%.The lower limits of normal value(LLN)the actual/predicted-%for each parameter were as follows:FVC 84.70%,FEV_(1)88.50%,FEV_(1)/FVC 96.00%,PEF 79.50%,MEF_(75)77.20%,MEF_(50)66.00%,MEF_(25)56.70%,MMEF 67.10%,MVV 108.80%.Conclusion There are differences between the Zapletal predicted values and the levels of each parameter of pulmonary ventilation function in healthy children aged 3-12 years old in Chongqing.And its clinical application has some limitations,and the pulmonary ventilation function should be evaluated comprehensively.