中国澳門健康成人脈衝振蕩肺功能測定及預計值方程式探討

A pilot study to evaluate Macao adults predictive equations for the impulse oscillometry system

目的探討澳門健康成人脈衝振蕩(impulse oscillometry system,IOS)肺功能特點,建立適合澳門健康成人的IOS預計值方程式。方法隨機選取362例無吸煙史的澳門籍漢族健康成人。採用德國Jaeger公司生產的MasterScreen脈衝振蕩肺功能測定儀,先進行常規肺量計檢測,肺功能正常者按照歐洲呼吸協會的標準測定氣道阻力,指標包括呼吸總阻抗(Zrs),5赫茲及20赫茲時呼吸阻力(R5、R20)和呼吸電抗(X5、X20);彈性阻力等於慣性阻力時的響應頻率(Fres)等,並將所得的實測值分別與年齡及性別行相關分析,並進行多元逐步綫性回歸分析,得出預計值方程式。結果上述氣道阻力指標在各年齡組間的差異無統計學意義;男女不同性別組有統計學意義;不同性別的氣道阻力各指標預計值方程式分別為:男:Z5=1.38-0.007*H+0.002*W;R5=1.316+0.002*W-0.007*H;R20=0.976-0.004*H;X5=-0.432+0.002*H;X20=-0.037-0.0004*AGE+0.001*H;RF=25.81+0.033*AGE-0.099*H。女:Z5=0.802+0.002*AGE-0.004*H+0.001*CW;R5=0.227+0.001*AGE+0.003*CW-0.003*W;R20=0.878-0.003*H;X5=-0.420+0.002*H-0.001*AGE;X20=0.166-0.001*AGE-0.0004*CW;RF=3.70+0.086*AGE+0.093*CW-0.08*W。結論建立了適合澳門人群的IOS各主要指標的預計值方程式,建議推廣應用。

Objective To explore characteristics of pulse oscillation technique for lung function assessment in Macao healthy adults and establish its predictive equation.Methods A survey conducted on 362 healthy non-smoker Macao adults(179men,183women),age 18 to 78years from January 2011 to December 2012.Respiratory impedance(Zrs),respiratory resistance(Rrs),and reactance(Xrs)at 5 and 20 resonant frequency(Fres)were measured with Jaeger Masterscreen IOS instrument.Measurements were carried out during spontaneous breathing which corresponds the recommendation made by European Respiratory Society.Stepwise multiple regressions and linear regressions were carried out with SPSS 17.0 for windows statistical software to identify the best equations of IOS parameters using standing height,weight,age and gender as potential determinants.Results Macao predictive normal equations were generated and compared with current published equations.There were no statistical significance of the IOS parameters among different age groups,but there was statistical significance between both genders.Conclusion The predictive equations of IOS for Macao has been established and it has potential range of application in respiratory diseases and population screening for health assessment.