The Differences of Interstitial Lung Diseases in High-Resolution Computerized Tomography and Pulmonary Function Test among Different Connective Tissue Diseases, and the Correlated Factors

Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.

Preoperative Exercise Testing Is a Better Predictor of Postoperative Complications than Pulmonary Function Testing for Patients with Lung Cancer

Objective: The aim of this preliminary study was to evaluate the feasibility of exercise testing (ET) for predicting postoperative complications in patients with impaired pulmonary function. Methods: Thirteen patients were prospectively enrolled. The enrollment criteria were FEV1.0% 8 by the Goddard classification or interstitial pneumonia on chest computed tomography. Patients underwent testing for pulmonary function, six-minute walking test (6MWT), and stair-climbing test (SCT). Postoperative cardiopulmonary complications (PCPCs) were recorded. Results: Four patients developed PCPCs. There were no significant differences between the patients with PCPCs (n = 4) and those without PCPCs (n = 9) for background data and PFT. The distances achieved in the 6MWT were 503 ± 72.7 m for patients without PCPCs and 369 ± 50.7 m for patients with PCPCs (p = 0.011). The SCT climbing heights were 20.4 ± 5.3 m for patients without PCPCs and 14.9 ± 4.0 m for patients with PCPCs (P = 0.187). Cut-off points, including a 6MFT distance of less than 400 m, SCT height lower than 15 m, and SCT climbing speed less than 8.5 m/min, were predictive of CPCP. Conclusions: Exercise testing is more feasible for predicting postoperative cardiopulmonary complications than stationary pulmonary function testing.

Clinical Significance of Pulmonary Function Tests in Long-Term Survivors after Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation

We retrospectively assessed long-term pulmonary function in adults surviving for ≥5 years after myeloablative allogeneic hematopoietic stem cell transplantation and identified risk factors for late-onset noninfectious pulmonary complications. Among 174 patients undergoing transplantation for hematologic malignancies between May 1994 and December 2004, 81 long-term survivors were evaluated. Pulmonary function tests (PFTs) were performed before conditioning, 3 months and 1 year after transplantation, and then annually. Eight patients (10%) had abnormal pulmonary function before transplantation, but this was not associated with late changes in PFTs. Patients with chronic graft-versus-host disease (GVHD) showed a significant decline of lung function after 3 years when compared with patients without chronic GVHD. Abnormal pretransplantation lung function was associated with pulmonary chronic GVHD according to National Institutes of Health criteria (score 0, n = 58;score 1, n = 14;score 2, n = 6;score 3, n = 3). Five patients with late-onset noninfectious pulmonary complications showed a decline of lung function at 1 year after transplantation. Only chronic GVHD was significantly related to late-onset noninfectious pulmonary complications. In conclusion, abnormal lung function before transplantation may be associated with a decline in pulmonary function within 1 year after transplantation, but late-onset noninfectious pulmonary complications could not be predicted from pretransplantation lung function.

Occupational Health Surveillance: Pulmonary Function Test in Proppant Exposures

Workers involved in hydraulic fracking processes are exposed to various types of chemicals and dusts in their workplaces, such as proppants, which hold open the fissures created in the fracking process. Recently, ceramic proppants have been developed that may be less hazardous to workers than traditional proppants. Pulmonary function testing of workers producing ceramic proppant was used to assess the potential inhalation hazards of ceramic proppant. 100 male workers from a producer of ceramic proppant were evaluated with pulmonary function test data collected and evaluated using The American Thoracic Society (ATS) acceptability criteria. A comparison group was selected from the Third National Health and Nutrition Examination Survey (NHANES III) spirometry laboratory subset. No pulmonary function deficits were found in the worker group in comparison to the NHANES III population. Mean FEV1 and FVC values in workers were 3.8 and 4.8 liters respectively, and were greater as compared to the NHANES III population of similar demographics. An FEV1/FVC ratio of less than 0.8, when compared to the NHANES III group, produced an odds ratio of 0.44 in worker group, indicating less risk of preclinical pulmonary dysfunction. Overall, exposure to ceramic proppant was not found to produce an adverse impact on pulmonary function in workers engaged in the manufacture of ceramic proppant.

Respiratory Tract, Ventilation, and Pulmonary Functions Tests

Breathing is considered the common factor that links studying,sleeping,and activities.It is one of the primary indicators that is frequently considered when determining whether or not an unconscious individual is still alive.The evolution and development process of the respiratory system that occurs in a foetus is primarily from head to tail(cephalocaudal).Many changes occur throughout this period until the 28th week of pregnancy at which the foetus^respiratory system will attain adequate development for the rest of his or her life.The respiratory system comprises of the lungs and the encompassing thoracic wall,which includes the thoracic cages,midriff(diaphragm),and the abdominal wall.Spirometry is a procedure used for estimating air volumes that enter and exit the pulmonary system with the aid of a spirometer.The various pulmonary parameters that reflect pulmonary ventilation are of great significance in diagnosing respiratory diseases.The respiratory system will be discussed in more detail in this article.

Is forced oscillation technique the next respiratory function test of choice in childhood asthma

Respiratory diseases, especially asthma, are common in children. While spirometry contributes to asthma diagnosis and management in older children, it has a limited role in younger children whom are often unable to perform forced expiratory manoeuvre. The development of novel diagnostic methods which require minimal effort, such as forced oscillation technique(FOT) is, therefore, a welcome and promising addition. FOT involves applying external, small amplitude oscillations to the respiratory system during tidal breathing. Therefore, it requires minimal effort and cooperation. The FOT has the potential to facilitate asthma diagnosis and management in preschool children by faciliting the objective measurement of baseline lung function and airway reactivity in children unable to successfully perform spirometry. Traditionally the use of FOT was limited to specialised centres. However, the availability of commercial equipment resulted in its use both in research and in clinical practice. In this article, we review the available literature on the use of FOT in childhood asthma. The technical aspects of FOT are described followed by a discussion of its practical aspects in the clinical field including the measurement of baseline lung function and associated reference ranges, bronchodilator responsiveness and bronchial hyperresponsiveness. We also highlight the difficulties and limitations that might be encountered and future research directions.

Effects of left ventricular assist device on pulmonary functions and pulmonary hemodynamics:A meta-analysis

BACKGROUND Given current evidence,the effect of left ventricular assist device(LVAD)implantation on pulmonary function tests remains controversial.AIM To better understand the factors contributing to the changes seen on pulmonary function testing and the correlation with pulmonary hemodynamics after LVAD implantation.METHODS Electronic databases were queried to identify relevant articles.The summary effect size was estimated as a difference of overall means and standard deviation on a random-effects model.RESULTS A total of four studies comprising 219 patients were included.The overall mean forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and diffusion lung capacity of carbon monoxide(DLCO)after LVAD implantation were significantly lower by 0.23 L(95%CI:0.11-0.34,P=00002),0.18 L(95%CI:0.03-0.34,P=0.02),and 3.16 mmol/min(95%CI:2.17-4.14,P<0.00001),respectively.The net post-LVAD mean value of the cardiac index was significantly higher by 0.49 L/min/m2(95%CI:0.31-0.66,P<0.00001)compared to pre-LVAD value.The pulmonary capillary wedge pressure and pulmonary vascular resistance were significantly reduced after LVAD implantation by 8.56 mmHg(95%CI:3.78-13.35,P=0.0004),and 0.83 Woods U(95%CI:0.11-1.55,P=0.02),respectively.There was no significant difference observed in the right atrial pressure after LVAD implantation(0.61 mmHg,95%CI:-2.00 to 3.32,P=0.65).Overall findings appear to be driven by studies using HeartMateII devices.CONCLUSION LVAD implantation might be associated with a significant reduction of the spirometric measures,including FEV1,FVC,and DLCO,and an overall improvement of pulmonary hemodynamics.

Impact of Cystic versus Cylindrical Types of Bronchiectasis on Pulmonary and Cardiac Functions

Background: The combination of the clinical features, HRCT score and echocardiographic evidence of pulmonary hypertension help assess the prognosis in bronchiectasis. Aim: To test whether pulmonary and cardiac functions associated with bronchiectasis would differ according to its type (cystic versus cylindrical) utilizing HRCT score, PFTs and echocardiography. Patients and Methods: A cross-sectional study of patients with bronchiectasis was conducted at Chest and Internal Medicine Departments at Assiut University Hospital, Egypt. The diagnosis of bronchiectasis type was based on HRCT findings. PFTs, HRCT score and echocardiography were assessed in all cases. Results: We studied 56 patients with bronchiectasis;31 were cystic (group A) and 25 were cylindrical (group B). Forced vital capacity (FVC%) and Dlco% were significantly lower in group A (P as compared with group B;whereas FEF 25%-75% and FEV1 (0.04) were lower in group B. Global HRCT score, RVD and SPAP were significantly higher in group A (P = 0.002) and correlated with FEV1% (r = ?0.51), and with SPAP (r = 0.16). Conclusions: Airway obstruction and small airway dysfunction were more significantly seen in cylindrical bronchiectasis. Patients with cystic bronchiectasis had significantly, higher global HRCT scores, RVD and SPAP. HRCT scores correlate with FEV 1% and SPAP and could be a predictor of future PH. Routine echocardiographic assessment of patients with bronchiectasis, particularly in those with cystic disease is highly recommended.

Immediate effect of fomentation on pulmonary function in patient with bronchial asthma:a case series

Background:Asthma is a major non-communicable disease affecting both children and adult populations,characterized by inflammation and narrowing of airways.Hydrotherapy is a naturopathy treatment modality effectively used to manage bronchial asthma.This case series presents the immediate effect of one such hydrotherapy treatment hot fomentation on pulmonary function in bronchial asthma.Case presentation:Three women who had chief complaints of wheezing,sneeze and breathlessness due to chronic bronchial asthma.Hot fomentation over the inter-scapular region was given to the patient for a duration of 20 minutes.Pulmonary function test was performed using Recorders&Medicine Systems Pvt Ltd.Helios 401 before and immediately after the intervention to assess the efficacy of hot fomentation.Result:When compared to baseline,the pulmonary function’s parameters,such as forced vital capacity,forced expiratory volume in the first second,forced expiratory volume in the first second/forced vital capacity ratio,forced expiratory flow(25–75%)and peak expiratory flow showed significant improvement immediately after the fomentation.Conclusion:After 20 minutes of hot fomentation,significant improvement in pulmonary function was observed.Hot fomentation over the interscapular region,could thus be used to improve clinical outcomes in the management of bronchial asthma by improving pulmonary function and relieving acute symptoms.

远程医疗管理在老年中重度慢性阻塞性肺疾病患者稳定期呼吸康复中的效果:一项随机对照研究

背景我国慢性阻塞性肺疾病(COPD)患者数量巨大,呼吸康复训练作为COPD患者稳定期管理的重要部分,可有效提高患者肺功能及生活质量,减少家庭及社会负担,国外有研究数据显示远程医疗管理下实施呼吸康复可提高患者的肺功能和生活质量(QOL)评分,但是国内,尤其是西部尚缺乏相关实践。目的评估通过远程医疗管理进行呼吸康复训练与传统治疗相结合对老年中重度COPD患者通气能力及肺功能的影响。方法本研究为前瞻性随机对照研究,连续性纳入2021年6月—2022年6月就诊于四川省第四人民医院及5个联合社区的COPD患者,采用随机数字表进行简单随机分组,将患者分为试验组和对照组。对照组接受传统的长期规律吸入支气管扩张剂及口服药物治疗,试验组在对照组治疗方案的基础上采用远程医疗管理。对两组患者进行为期6个月的研究,分别在基线时及干预1、3、6个月后记录患者的肺功能、博格评分(Borg评分)、6 min步行试验(6MWT)、QOL评分。结果研究对象分为对照组(72例)和试验组(73例),两组患者的性别、年龄及基线时肺功能[第1秒用力呼气末容积占预计值百分比(FEV_(1)%pred)及第1秒用力呼气末容积与用力肺活量(FVC)的比值(FEV_(1)/FVC)]比较,差异均无统计学意义(P>0.05)。时间和组间对FEV_(1)%pred、FEV_(1)/FVC、6MWT水平、QOL评分中呼吸困难、情绪存在交互作用(P<0.05)。干预1、3、6个月后,试验组FEV_(1)%pred、FEV_(1)/FVC、Borg评分、6MWT、QOL评分优于对照组(P<0.05);干预3、6个月后,试验组FEV_(1)%pred、FEV_(1)/FVC、Borg评分、6MWT、QOL评分优于干预后1个月时(P<0.05)。结论采用远程医疗管理对老年中重度COPD稳定期患者进行呼吸康复,干预3、6个月后能有效改善该类患者肺功能,提高生活质量及生存质量。

PBL联合CBL教学法在儿童肺功能临床见习教学中的应用

目的:探索PBL联合CBL教学法在儿童肺功能临床见习教学中的应用效果。方法:将呼吸专科护士培训班45名学员随机分为对照组和试验组,在临床见习中分别实施CBL教学法和PBL联合CBL的教学法,比较两组学员考试成绩及教学效果主观评价情况。结果:试验组学员考试成绩及教学效果的总体主观评价均明显高于对照组(P<0.05)。结论:在理论课时较少且学员学习基础较薄弱的肺功能临床见习教学实践中,PBL联合CBL教学法更有利于学员对难点内容的理解和掌握,可有效提高教学质量,得到学员的认可和喜爱。

肺功能检查联合5A行为干预的短期戒烟效果评价

目的:探讨肺功能检查和宣教联合5A行为干预的短期戒烟效果。方法:选取2019年5月—2021年12月在汕头大学医学院第一附属医院呼吸科门诊就诊且有吸烟史的439例患者为研究对象,均为男性,年龄(54.9±12.5)岁。根据患者的意愿分为肺功能检查联合5A行为干预组(干预组,224例)和仅实施5A行为干预组(对照组,215例),干预时间1个月。采用成功戒烟率及烟草依赖程度评价短期戒烟效果。采用logistic回归分析评价肺功能检查和宣教联合5A行为干预的戒烟效果。以倾向性得分匹配进行敏感性分析,评估多因素logistic回归分析结果的稳健性。结果:干预组的成功戒烟率为43.8%(98/224),对照组为13.5%(29/215),干预组的成功戒烟率高于对照组(χ^(2)=48.86,P<0.001)。在干预后戒烟失败患者中,干预组的重度烟草依赖患者占比较干预前下降,且低于对照组,差异具有统计学意义(干预前重度烟草依赖:35.7%比34.9%;干预后重度烟草依赖:19.1%比29.6%)。多因素logistic回归分析显示,与对照组相比,干预组短期成功戒烟率增高(OR=3.92,95%CI:2.18~7.06),干预组中戒烟失败患者的烟草依赖度降低(OR=4.34,95%CI:1.72~10.92)。结论:肺功能检查和宣教联合5A行为干预可能在短期内有助于提高呼吸科门诊吸烟患者的戒烟成功率,降低戒烟失败患者的烟草依赖程度。

分级八段锦康复干预对COPD稳定期患者肺功能、疲乏状况及糖脂代谢的影响

【目的】探讨分级八段锦康复干预对慢性阻塞性肺疾病(COPD)稳定期患者肺功能、疲乏状况以及糖脂代谢的影响。【方法】选择2018年1月至2021年1月本院收治的98例COPD患者,采用随机数字表法将其分为观察组和对照组,每组49例。对照组给予常规药物及康复干预,观察组在对照组的基础上联合分级八段锦康复节操进行干预。对比两组肺功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)以及二者比值(FEV_(1)/FVC)]、疲乏程度、糖脂代谢指标[总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、糖化血红蛋白(HbA1c)]。【结果】干预后,两组患者肺功能指标与干预前比较,两组间比较,差异均无统计学意义(P>0.05)。干预后,两组患者机体疲乏评分、脑力疲乏评分及总分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组患者TC、TG、HbA1c均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05);两组HDL-C与干预前及组间比较,差异无统计学意义(P>0.05)。【结论】分级八段锦康复干预可改善COPD患者疲乏状况及糖脂代谢水平,对于提高患者生活质量具有重要作用。

基于CT图像的深度神经网络肺功能预测

我国流行病学调查结果显示,以慢阻肺和哮喘为代表的慢性呼吸系统疾病患病率高且呈现上升的趋势,给公共卫生健康带来了严重威胁.目前,计算机断层扫描(CT)作为一种方便、无创的方法被广泛应用于肺功能的评估.在基于CT图像的计算机辅助评估肺功能的方法中,人工设计的特征存在表达能力有限的问题,且现有的深度学习方法从高噪稀疏的小样本数据集中提取特征的效果较差.为了提高肺功能检查的效率,本文提出了基于CT图像的肺功能预测网络(LFP-ResNet).首先,本文提出了多层次上下文特征融合(MCFF)方法,有效增强了对表征肺部纹理和形态的特征提取;其次,利用三维残差网络充分保证了CT图像的空间异质性;最后,本文构建了包含肺功能正常人群和患有慢性呼吸系统疾病患者的肺功能数据集,并在该数据集上对比了本工作提出的方法以及其他先进的肺功能预测方法 .实验结果表明,本文提出的MCFF策略在含噪声的稀疏矩阵中提取特征时比其他特征提取方法更有效,且所构建的LFP-ResNet在肺功能预测任务中表现出更好的预测性能.

慢性阻塞性肺疾病MSCT肺测量与PFT检查的对比研究

目的探讨慢性阻塞性肺疾病(COPD)患者多排螺旋CT(MSCT)肺测量指标与肺功能检查(PFT)指标的相关性。方法选择2015年6月至2016年3月因COPD入成都医学院第一附属医院治疗,且同时行MSCT和PFT检查CT容积重建成功的患者共70例;双肺各选择上、中、下3个层面点值法测量肺CT值,再利用后处理软件分析全肺容积及肺气肿率,行肺CT值、肺容积、肺气肿率与PFT检查结果的相关性。结果双肺上、中、下3个层面肺CT值与FEV1%具有较强的相关性(P<0.05),右侧、左中层面CT值与RV/TLC弱相关(P<0.05),全肺平均CT值与FEV1%、FEV1/FVC和RV/TLC具有较强的相关性(P<0.05)。CT测量肺总容积与TLC、MVC、RV和RV/TLC弱相关(P<0.05)。CT测量肺气肿率与PFT各指标均有相关性(P<0.05),其中,与RV/TLC、FEV1%的相关性较强(rs>0.5)。结论 MSCT肺部扫描CT值、肺容积及肺气肿率等测量值与PFT部分指标具有相关性,具有辅助评估COPD患者肺通气功能的应用价值。

慢性阻塞性肺疾病CT定量参数改变及其与肺功能指标的关系

目的观察未经治疗COPD患者CT定量参数变化及其与肺功能指标的关系。方法回顾性分析99例未经治疗COPD患者资料;根据气流受限程度分为A组(GOLD 1级,轻度受限,36例)、B组(GOLD 2级,中度受限,37例)及C组(GOLD 3、4级,明显受限,26例);分析首检及随访胸部CT定量参数、肺功能指标的差异及其相关性。CT定量参数包括全肺容积、低衰减区百分比(LAA%)、肺血管总计数与肺表面积比值(N_(total)/LSA)、截面积_(<5 mm^(2))的肺血管计数与肺表面积比值(N_(<5 mm^(2))/LSA)、理论气道内周长为10 mm的管壁面积平方根(Pi10)、全肺气道壁体积、壁厚及壁面积百分比(WA%)等,而肺功能指标包括吸入支气管舒张剂后第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及二者比值(FEV_(1)/FVC)和FEV_(1)率(FEV_(1)%)。结果相比首检各项指标,随访时各组FVC、FEV_(1)、FEV_(1)/FVC,以及N_(total)/LSA、N_(<5 mm^(2))/LSA均降低(P均<0.05),而LAA%、Pi10及全肺气道壁体积均升高(P均<0.05)。相比A组,B、C组LAA%降低而Pi10升高,且幅度随气流受限程度加重而增加(P均<0.05)。LAA%、Pi10及全肺气道壁体积与肺功能指标呈负相关(P均<0.05);N_(total)/LSA、N_(<5 mm^(2))/LSA与肺功能指标呈正相关(P均<0.05)。结论定量CT参数LAA%、N_(total)/LSA、N_(<5 mm^(2))/LSA、Pi10及全肺气道壁体积均与肺功能相关,能较好反映COPD气道及血管纵向变化。

PBL联合CBL教学法在儿童肺功能检测进修教学中的应用

目的探讨以问题为基础的教学法(problem based learning,PBL)联合以案例为基础的教学法(case based learning,CBL)在儿童肺功能专科进修培训中的应用效果。方法以2020年1月—2022年12月25名在四川大学华西第二医院肺功能专科的进修人员为调查对象,应用PBL联合CBL教学法,比较进修前后的理论知识与实际操作水平、胜任力水平,并调查进修人员对培训的满意度。结果经过一段时间理论和实践的培训,进修人员理论知识和实践技能操作水平以及胜任力水平较进修前均得到较大提升,培训前理论知识水平、实际操作和胜任力水平评分分别为(22.48±9.52)分、(15.40±5.97)分和(21.04±6.47)分,培训后理论知识水平、实际操作和胜任力水平评分分别为(75.00±24.00)分、(58.84±19.44)分和(65.32±17.39)分,培训前后差异有统计学意义(P<0.05)。肺功能检测进修人员对肺功能检测室整体工作环境比较满意。结论在PBL联合CBL教学法模式下,进修人员的理论知识与实际操作水平均有不同程度的提高,胜任力水平有较大提升,PBL联合CBL教学法可有效提高肺功能专科进修培训效果,肺功能检测应不断规范培训流程,完善肺功能检测进修体系,提升肺功能检测进修人员综合素质与学习满意度。

肺功能检查在慢性阻塞性肺疾病合并心血管疾病中的应用

慢性阻塞性肺疾病(简称慢阻肺)和心血管疾病都具有患病率高、疾病负担重的特点,现在已有大量研究表明两者存在相互影响。目前临床上对慢阻肺合并心血管疾病普遍认识不足,导致合并症的处理在疾病的诊治过程中易被忽略。肺功能检查在二者合并或鉴别诊断中都具有重要的临床应用价值,可为病情进展和预后情况等提供重要依据。本文旨在帮助提高临床医务人员对慢阻肺合并心血管疾病的认识,同时利用肺功能检查识别和恰当处理慢阻肺,提高疾病的综合诊治水平。

健康体检人群血尿酸与气流阻塞的相关性

目的:探讨中国台湾健康体检人群中血尿酸水平与肺功能指标和气流阻塞之间的相关性。方法:利用中国台湾美兆健康资源中心的体检资料,选取于1996—2016年间进行体检的40岁以上人群进行横断面分析,按照性别分别进行血尿酸水平与肺功能指标的相关性分析,以及血尿酸水平对气流阻塞影响的Logistic回归分析。结果:共纳入35465人,平均年龄(45.70±7.30)岁,男性16411人,女性19054人,其中,男性的血尿酸水平高于女性,存在气流阻塞的人群血尿酸水平高于无气流阻塞的人群。女性血尿酸水平与肺功能指标[第一秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(force vital capacity,FVC)]之间呈负相关(P<0.05),男性血尿酸水平与肺功能指标FEV1、FVC之间则无显著相关性(P>0.05)。在调整年龄、教育程度、吸烟、饮酒、工作强度、体重指数、是否咳嗽、高血压病史、糖尿病病史等指标,以及白细胞、白蛋白等生化指标后,随着血尿酸浓度的升高,女性更易存在气流阻塞(OR=1.12,95%CI:1.02~1.22,P<0.05)。按照是否患高尿酸血症进行分组,结果显示与血尿酸正常组相比,女性中高尿酸血症组更易存在气流阻塞(OR=1.36,95%CI:1.06~1.75,P<0.05),而男性中血尿酸浓度与气流阻塞患病之间无显著相关性(OR=1.04,95%CI:0.96~1.13,P>0.05),是否患高尿酸血症与气流阻塞的存在无显著相关性(OR=1.12,95%CI:0.89~1.39,P>0.05)。结论:女性健康体检人群中,血尿酸水平与肺功能指标FEV1、FVC之间存在负相关,高尿酸血症与气流阻塞的存在有相关性,在男性中则不明显。未来仍需要前瞻性研究来进一步验证高血尿酸水平是否与气流阻塞的发生相关联。

支气管哮喘儿童IOS指标与PFT指标的变化及相关性分析

目的探讨支气管哮喘儿童脉冲振荡肺功能检查(IOS)指标与常规肺功能检查(PFT)指标的变化及其相关性。方法回顾性分析2020年1月至2021年3月东莞市人民医院收治的100例支气管哮喘患儿的临床资料,根据患儿病情不同分为急性发作期21例、慢性持续期54例和临床缓解期25例。比较三组患儿的IOS指标[呼吸总阻抗(Zrs)、呼吸道总阻力(R_(5))、中心呼吸道阻力(R_(20))、周边呼吸道阻力(R_(5)~R_(20))、周边弹性阻力(X_(5))、响应频率(Fres)]以及PFT指标[第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、呼气峰值流量(PEF)、用力呼出25%、50%、75%肺活量时的瞬间呼气流量(PEF_(25)、PEF_(50)、PEF_(75))及最大呼气中期流量(MMEF)],并采用Pearson相关性分析法分析IOS指标和PFT指标的相关性。结果急性发作期患儿Zrs、R_(5)、R_(20)、R_(5)~R_(20)、X_(5)、Fres分别为(1.33±0.19)kPa/(L·s)、(126.82±20.51)%pred、(98.67±9.10)%pred、(198.75±25.17)%pred、(143.03±17.86)%pred、(18.76±2.10)Hz,明显高于慢性持续期患儿的(1.17±0.16)kPa/(L·s)、(84.19±15.66)%pred、(83.32±7.69)%pred、(109.24±16.53)%pred、(79.23±10.14)%pred、(12.05±1.73)Hz和临床缓解期患儿的(0.92±0.14)kPa/(L·s)、(72.53±10.74)%pred、(73.00±7.15)%pred、(85.81±10.62)%pred、(45.96±6.92)%pred、(8.42±1.61)Hz,且慢性持续期患儿上述指标均明显高于临床缓解期,差异均有统计学意义(P<0.05);急性发作期患儿FEV1、FEV1/FVC、PEF、PEF_(25)、PEF_(50)、PEF_(75)、MMEF分别为(1.28±0.13)L、(76.50±4.86)%、(2.40±0.36)L/s、(1.98±0.16)L/s、(1.05±0.14)L/s、(0.50±0.06)L/s、(0.96±0.08)L/s,明显低于慢性持续期患儿的(1.43±0.15)L、(85.61±6.77)%、(3.51±0.44)L/s、(2.57±0.26)L/s、(1.63±0.17)L/s、(0.78±0.10)L/s、(1.28±0.13)L/s和临床缓解期患儿的(1.57±0.16)L、(93.15±5.48)%、(4.60±0.53)L/s、(3.69±0.40)L/s、(2.50±0.23)L/s、(1.06±0.12)L/s、(1.52±0.18)L/s,且慢性持续期患儿上述指标均明显低于临床缓解期患儿,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,IOS与PFT各项指标均呈负相关(P<0.05)。结论支气管哮喘患儿IOS指标与PFT指标之间具有明显的负相关,IOS对临床诊断更有意义,临床应用价值高。