慢性阻塞性肺疾病患者最大通气量推算公式的建立  

Establishment of regression formulae of maximal voluntary ventilation in patients with chronic obstructive pulmonary diseases

作　　者：袁玉如[1] 梁斌苗[1] 曾继军[1] 何太灵[1] 

机构地区：[1]四川大学华西医院呼吸内科,四川省成都市610041

出　　处：《中国临床康复》2005年第47期61-63,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的探求更科学、合理反映慢性阻塞性肺疾病患者真实情况的最大通气量的推算公式。方法①选择2003-03/2004-04四川大学华西医院呼吸内科门诊的稳定期慢性阻塞性肺疾病患者721例。均对实验目的知情同意。②以慢性阻塞性肺疾病的严重程度分级标准(GOLD方案)将721例慢性阻塞性肺疾病进行分度轻度慢性阻塞性肺疾病281例(男247例,女34例),中度慢性阻塞性肺疾病316例(男248例,女68例),重度慢性阻塞性肺疾病124例(男87例,女37例)。③采用6200型体积描记仪对其行最大通气量及最大呼气流量-容积曲线测定,以3组慢性阻塞性肺疾病患者实测最大通气量与以往采用(以正常人测值所推导)的最大通气量推算公式所得间接最大通气量相比较;并以慢性阻塞性肺疾病患者肺功能实测值为自变量,实测最大通气量为应变量,应用逐步回归法取得中、重度慢性阻塞性肺疾病患者推算最大通气量的最佳回归公式。④行多样本均数比较的方差分析及直线相关分析。结果慢性阻塞性肺疾病患者721例均进入结果分析。①轻度慢性阻塞性肺疾病应用以往公式所得结果与实测最大通气量较吻合(t=0.349,P=0.727),提示轻度慢性阻塞性肺疾病患者可应用以正常人第1秒用力呼气量推导的最大通气量推算公式[最大通气量推1(L)=30.2第1秒用力呼气量(L)+10.85,最大通气量推2(L)=45.12第1秒用力呼气量(L)-15.85]。②正常人第1秒用力呼气量推导的最大通气量推算公式不适宜中、重度慢性阻塞性肺疾病患者,推算值与实测值间差异明显(t=11.463～18.067,P=0.000)。③在众多肺功能指标中,慢性阻塞性肺疾病患者仍以第1秒用力呼气量与最大通气量具有最好的相关性(r=0.922,P=0.000)。④推出以中、重度慢性阻塞性肺疾病患者实测第1秒用力呼气量所得最大通气量推算公式,中度慢性阻塞性肺疾病患者最大通气量推算值公式=AIM： To investigate more seientific reasonable furmulae for calculation of maximal voluntary, ventilation （MVV） in patients with ehronic obstructive pulmonary disease （COPD）. METHODS： （1） 721 patients with steady COPD from ont-patient clinic of Department of Respiratory Medicine, West China ttospital, Sichuan University from Mareh 2003 to April 2004 were admitted into the study, and all the patients agreed to join the experiment. @ Grading the 721 patients on their severe degree of COPD according to GOLD program： 281 cases in mild grade （247 males, 34 females）, 316 in moderate grade （248 males, 68 females）, and 124 in severe grade （87 males, 37 females）. （3） MVV and maximal expiratory flow-volume curve （MEFV） tests were taken on all patients with 6200-plethysmography. The actual measuring values of MVV from all patients of the three groups were compared against their calculated MVVs from current formulae, which was established by measurements on normal subjects. And a more reasonable MVV regression formula for moderate and severe COPD was deduced with the actual values of pulmonary function parameters of these patients as independent variable and actual MVV as the dependent variable by progressive regression. （4） Statistical analysis were done by analysis of variance of muhiple sample means and linear correlation. RESULTS： All data from the 721 patients were put into the result analysis. （1）In patients with mild COPD, the actual MVVs were consisted with the MVVs calculated by current formula （t=0.349, P=0.727）, which suggested that the current formulae for MVVs deduced from the FEVI of normal subjects could be used in patients with mild COPD （deduced formula i： MVV （L）=30.2 FEVI （L）＋10.85; deduced formula2： MVV （L） = 45.12 FEVI （L）-15.85）. （2）The MVVs caleulated by current formula deduced from the FEVI of normal subjects were not fit into the actual MVVs in patients with moderate and severe COPD. The difference between the actual MV

关 键 词：肺疾病 慢性阻塞性 呼吸功能试验 最大通气量 

分 类 号：R587.1[医药卫生—内分泌]