FEV_(1)和FVC正常范围时流量-容积曲线判读的临床价值  

Clinical value of F-V curve interpretation in individuals with normal FEV_(1) and FVC

作　　者：倪艾珺 李瑞久 李萍 陈幼花 孙培莉 Ni Aijun;Li Ruijiu;Li Ping;Chen Youhua;Sun Peili(Department of Pulmonary and Critical Care Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Pulmonary and Critical Care Medicine,Affiliated Hospital of Jiangsu University,Zhenjiang 212000,China;Department of Intensive Care Medicine,Nanjing Gaochun People′s Hospital,Nanjing 211306,China)

机构地区：[1]南京医科大学第一附属医院呼吸与危重症医学科,南京210029 [2]江苏大学附属医院呼吸与危重症医学科,镇江212000 [3]南京市高淳人民医院重症医学科,南京211306

出　　处：《中华结核和呼吸杂志》2023年第3期263-268,共6页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：国家重点研发计划专项(2018YFC1311900)。

摘　　要：目的探讨肺通气功能参数第1秒用力呼气容积(FEV_(1))和用力肺活量(FVC)正常范围时, 流量-容积(flow-volume, F-V)曲线图形判读与疾病的相关性。方法收集2021年1月在南京医科大学第一附属医院肺功能室使用德国耶格公司Master Screen IOS脉冲震荡肺功能仪进行肺功能检查的650例受检者肺功能报告, 选取FEV_(1)和FVC正常范围的受检者进行回顾性分析, 纳入呼气相图形分别表现为标准、小平台和锯齿三组图形共363例, 其中标准组254例、呼气小平台组(平台组)95例、呼气锯齿组(锯齿组)14例, 完善其基本资料、临床资料和肺功能结果。采用多元Logistic回归分析F-V曲线异常与疾病相关性。结果锯齿组体重及体重指数(BMI)明显高于标准组、平台组[体重分别为(76±32)、(66±11)和(65±10)kg, P=0.004;BMI分别为(27.5±9.9)、(24.1±3.2)、(23.9±2.7)kg/m^(2), P=0.003]。平台组上消化道疾病(OR=2.673, P<0.001)及咽喉部疾病(OR=4.738, P=0.008)与呼气小平台呈正相关;锯齿组鼾症、OSAHS(OR=26.111, P<0.001)及咽喉部疾病(OR=45.754, P<0.001)与呼气锯齿呈正相关。结论肺通气功能参数FEV_(1)和FVC正常范围的受试者中, 呼气相小平台的出现与上消化道疾病及咽喉部疾病相关。而呼气相锯齿的出现与鼾症、OSAHS及咽喉部疾病相关。结合F-V曲线图形和肺通气功能参数进行肺功能解读有利于人群健康筛查。Objective To analyze the correlation between the Flow-Volume(F-V)curve interpretation and diseases when the patient′s forced expiratory volume in one second(FEV_(1))and forced vital capacity(FVC)were within the normal range.Methods In January 2021,the pulmonary function test(PFT)reports of 650 subjects who performed pulmonary function tests using a standard equipment(Master Screen IOS,Jaeger crop,German)were collected in the First Affiliated Hospital of Nanjing Medical University.A total of 363 subjects with normal FEV_(1) and FVC were selected for retrospective analysis,including 254 cases with standard F-V curve(standard group),95 cases with“small plateau sign”F-V curve(plateau group)and 14 cases with“sawtooth sign”F-V curve(sawtooth group).The basic information,clinical information and pulmonary function test results of these subjects were collected.Multiple logistic regression analysis was conducted to determine the correlation between the abnormal F-V curves and diseases.Results The patients in the sawtooth group were significantly heavier and had a higher BMI than those in the standard and the plateau groups(76±32,66±11,65±10,P=0.004;27.5±9.9,24.1±3.2,23.9±2.7,P=0.003).Compared with the standard group,upper gastrointestinal disease(OR=2.673,P<0.001)and throat disease(OR=4.738,P=0.008)were positively correlated to the plateau group.Sleep apnea syndrome,OSAHS(OR=26.111,P<0.001)and throat disease(OR=45.754,P<0.001)were positively correlated to the sawtooth group.Conclusions In patients with normal FEV_(1) and FVC,the presence of“small plateau sign”F-V curve could be associated with upper gastrointestinal disease and throat disease,while the presence of“sawtooth sign”F-V curve could be associated with sleep apnea syndrome,OSAHS and throat diseases.Combining the F-V curve and parameters of pulmonary ventilation function to interpret pulmonary function is beneficial to population health screening.

关 键 词：最大呼气流量-容积曲线 肺功能检查 睡眠呼吸暂停 阻塞性 早期诊断 

分 类 号：R56[医药卫生—呼吸系统]