扬州地区11~12岁健康儿童肺通气功能预测值构建

Construction of predictive value of pulmonary ventilation function in healthy children aged 11 to 12 years in Yangzhou

目的构建江苏扬州地区11~12岁健康儿童肺功能参数的预计方程式。方法前瞻性选择扬州地区5所小学的595名11~12岁健康儿童作为研究对象,其中男334名、女261名,采用肺功能仪测定其肺通气功能。以呼气流量峰值(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、一秒率(FEV_(1)/FVC)4项参数实测值为因变量,以年龄、身高、体质量、体质量指数为自变量,通过多元逐步回归分析建立不同性别儿童的肺功能预计方程式,并采用相对预测误差平均值评价预计方程式的适用性。结果12岁男童的身高、体质量、体质量指数和PEF、FEV_(1)、FVC水平均高于11岁男童,12岁女童的身高、体质量、体质量指数、收缩压、舒张压和FEV_(1)、FVC水平均高于11岁女童,差异有统计学意义(P<0.05);11岁男童的血压、体质量指数均高于11岁女童,12岁男童的身高低于12岁女童,体质量指数高于12岁女童,差异有统计学意义(P<0.05)。相关性分析结果显示,男童的年龄、身高、体质量、体质量指数均与PEF、FEV_(1)、FVC分别呈正相关(P<0.01),身高与FEV_(1)/FVC呈负相关(P<0.01);女童的身高、体质量、体质量指数均与FEV_(1)、PEF分别呈正相关(P<0.01或P<0.05),年龄与FEV_(1)呈正相关(P<0.01)。男童肺功能预计方程式分别为PEF(L/s)=0.032H+0.261A-4.306,FEV_(1)(L)=0.028H+0.092A-3.098,FVC(L)=0.042H+0.101A-4.858,女童肺功能预计方程式分别为PEF(L/s)=0.040H-2.855,FEV_(1)(L)=0.033H-2.935,其中H指身高(cm),A指年龄(岁)。与其他研究的预计方程式相比,本研究构建的回归方程对本研究群体有较好的适用性。结论本研究构建的扬州地区11~12岁健康儿童肺通气功能主要参数预计方程式,可为该地区儿童肺通气功能相关参数的预测提供帮助,进而为临床准确判定儿童肺功能异常奠定基础。

Objective To construct a predictive equation of pulmonary function parameters in healthy children aged 11 to 12 years in Yangzhou.Methods A total of 595 healthy children aged 11 to 12 years old from 5 primary schools in Yangzhou were prospectively selected as subjects,including 334 males and 261 females.Lung function instrument was used to measure their lung ventilation function.Taking measured values of peak expiratory flow(PEF),forced vital capacity(FVC),forced expiratory volume in the first second(FEV_(1))and FEV_(1) to FVC ratio(FEV_(1)/FVC)as dependent variables and age,height,body mass and body mass index as independent variables,mean value of relative prediction error is used to evaluate the applicability of the prediction equation.Results Height,body weight,body mass index,PEF,FEV_(1) and FVC of 12-year-old boys were higher than those of 11-year-old boys,and height,body mass,body mass index,systolic blood pressure,diastolic blood pressure,FEV_(1)and FVC levels of 12-year-old girls were higher than those of 11-year-old girls,and the differences were statistically significant(P<0.05).The blood pressure and body mass index of the 11-year-old boys were higher than those of the 11-year-old girls,and the height of the 12-year-old boy was lower than that of the 12-year-old girls,and the body mass index of the 12-year-old boys was higher than that of the 12-year-old girls(P<0.05).Correlation analysis showed that age,height,body mass and body mass index of boys were positively correlated with PEF,FEV_(1)and FVC(P<0.01),and height was negatively correlated with FEV_(1)/FVC(P<0.01).The height,body mass and body mass index of girls were positively correlated with FEV_(1)and PEF(P<0.01 or P<0.05),and the age was positively correlated with FEV_(1)(P<0.01).The prediction equations for the reference values of each index in boys were PEF(L/s)=0.032H+0.261A-4.306,FEV_(1)(L)=0.028H+0.092A-3.098 and FVC(L)=0.042H+0.101A-4.858;the prediction equations for the reference values of each index in girls were PEF(L/s)=0.032H+0.261A-4.306,FEV_(1)(L)=0.028H+0.092A-3.098 and FVC(L)=0.042H+0.101A-4.858,H referring to height(cm)and A referring to age(years old).The results of the equation test compared with the predicted equations of other studies,and the regression equation constructed in this time had better applicability to the study group in the research.Conclusion In this study,the predicted equation of the main parameters of pulmonary ventilation function in children aged 11 to 12 years in Yangzhou can help to predict the related parameters of lung ventilation function of children in this area,thereby laying a foundation for the accurate diagnosis of children’s lung function abnormalities in clinic.