深圳地区学龄前儿童用力肺活量测定的可行性及正常预计值公式  

Feasibility and predicted equations of spirometry in Shenzhen preschool children

作　　者：张清玲[1] 郑劲平[2] 袁本通[1] 何桦[2] 王健[1] 安嘉颖[2] 张敏[1] 罗定芬[2] 陈桂莲[1] 

机构地区：[1]深圳市第二人民医院呼吸内科,518026 [2]广州医学院附属第一医院广州呼吸疾病研究所

出　　处：《中华儿科杂志》2005年第11期843-848,共6页Chinese Journal of Pediatrics

基　　金：深圳市科技项目基金(200404071)

摘　　要：目的探讨学龄前儿童用力肺活量测定的可行性,并建立儿童常规用力肺活量的正常参考值.方法对深圳地区3～6岁正常儿童343例(男性184例,女性159例), 采用意大利COSMED公司生产的COSMED流量传感仪,参考美国胸科协会可接受曲线标准,测定用力肺活量(FVC)、0.5 s用力呼气容积(FEV0.5)、0.75 s用力呼气容积(FEV0.75)、1 s用力呼气容积(FEV1)、0.5 s用力呼气容积占用力肺活量比值(FEV0.5/FVC)、0.75 s用力呼气容积占用力肺活量比值(FEV0.75/FVC)、1 s用力呼气容积占用力肺活量比值(FEV1/FVC)、最大呼气中段流量(FEF25%～75%)、最高呼气流量(PEF)、最高吸气流量(PIF)、呼气时间(FET100%)等11个指标,并对各实测指标作多元逐步线性回归及曲线回归,得出回归方程式.比较本方程与国外Nystad方程对指定身高、体重、年龄的儿童的差异.结果所有儿童测试的总成功率为81.3%,其中3～岁、4～岁、5～岁、6～岁各年龄段测试的成功率分别为69.9%、70.8%、92.3%、91.6%;217例(77.7%)可以完成至少2条可接受的曲线.FVC、FEV0.5、FEV0.75、FEV1、FEF25%～75%、PEF、PIF在各年龄组间差异均有统计学意义(P均<0.01);大多数肺功能指标与身高、体重和年龄均呈密切正相关,男性儿童的大多数肺功能指标与身高的关系最为密切,而女性儿童的大多数肺功能指标则与年龄的关系最为密切.所有儿童的呼气时间为(1.61±0.52) s(±s),5百分位数为0.9 s,受试儿童中有18例(6.5%)呼气时间<1 s.建立了各肺功能指标的多元回归方程.结论利用儿童心理特点,通过形象比喻、竞赛游戏的方法进行用力肺活量的测定在中国的学龄前儿童中也是可行的.男性儿童肺功能指标受身高变化影响大于体重和年龄变化;女性儿童肺功能指标受年龄变化影响大于身高和体重变化;首次建立了中国深圳地区学龄前儿童用力肺活量正常值及其回归方程式.Morbidity of chronic lung disease in young children is relatively high, and could increase in the future. Pulmonary function testing is used for clinical assessment of patients with suspected or obvious pulmonary disease to assess the severity of dysfunction and to evaluate therapeutic effectiveness. In the recent few years, forced expiratory parameters assessing lung function have been measured in older children. In order to assess abnormalities of lung function in preschool patients with respiratory disorders based on changes of forced expiratory parameters, adequate reference values are needed. However, such data in healthy preschool children remain scant in the literature. Objective The aim of this study was to characterize the spirometry of preschool children and establish the normal lung function prediction equations for Chinese preschool children. Methods A survey in 343 healthy preschool children （ 184 boys and 159 girls） aged 3 to 6 years （73 children aged 3 years,96 children aged4 years,91 children aged 5 years and 83 children aged 6 years） was carried out in Shenzhen in 2004. Eleven flow volume tests parameters, i. e. , forced vital capacity （ FVC）, forced expiratory volume at 0. 5 second （ FEV0.5 ）, forced expiratory volume at 0. 75 second （ FEV0.75 ）, forced expiratory volume at one second （ FEV1 ）, maximal mid expiratory flow rate （FEF25%-75% ）, peak expiratory flow （PEF）, forced expiratory time （FET100%） were measured by using COSMED spirometry produced in Italy, Stepwise multiple regressions and non-linear regressions were carried out with the statistical software SPSS10. 0 for Windows to identify the best predictors of lung function parameters using standing height, weight, age and gender as potential determinants. Results Spirometric tests could be successfully carried out by using imagery methods in the following percentages of children： 69. 9% of 3 to4 years old, 70. 8% of 4 to 5 years old, 92. 3% of 5 to 6 years old and 91.6% of 6 to 7 years old children,

关 键 词：肺通气 肺活量 儿童 学龄前 参考值 

分 类 号：R725.6[医药卫生—儿科]