支气管哮喘患者体重指数与肺功能指标的相关性及对患者管理的提示  

Correlation between body mass index and pulmonary function indexes in patients with bronchial asthma and suggestions for patient management

作　　者：徐丽平 黄雪梅[1] 杨美玲[1] 段敏超 邓静敏[1] Xu Liping;Huang Xuemei;Yang Meiling;Duan Minchao;Deng Jingmin(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Respiratory and Critical Care Medicine,Wuming Hospital Affiliated to Guangxi Medical University,Nanning 530199,China)

机构地区：[1]广西医科大学第一附属医院呼吸与危重症医学科,南宁530021 [2]广西医科大学附属武鸣医院呼吸与危重症医学科,南宁530199

出　　处：《中华健康管理学杂志》2023年第8期579-583,共5页Chinese Journal of Health Management

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2022078);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201237)。

摘　　要：目的分析支气管哮喘(简称哮喘)患者体重指数(BMI)与肺功能的相关性。方法本研究为回顾性横断面研究。连续性选取2013年3月至2022年11月于广西医科大学第一附属医院确诊并规范治疗及管理且符合纳入标准的哮喘患者828例,其中男292例,女536例;年龄21~82岁,中位年龄47岁。根据BMI将其分为高BMI组(BMI≥24 kg/m^(2))218例、正常BMI组(18.5 kg/m^(2)≤BMI<24 kg/m^(2))521例及低BMI组(BMI<18.5 kg/m^(2))89例。通过肺功能仪测定研究对象的用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC、最大呼气中期流速(MMEF)、呼出25%、50%以及75%肺活量时的呼气流速(FEF_(25%)、FEF_(50%)、FEF_(75%))、呼吸峰值流量(PEF)、吸入舒张剂(沙丁胺醇)后FVC和FEV_(1)实测值增加的绝对值及FVC%预计值(“%预计值”表示相关指标占预计值的百分比)和FEV_(1)%预计值增加的百分数,分析BMI与上述指标的相关性。结果高BMI组FEV_(1)%预计值、MMEF、FEF_(25%)、FEF_(50%)以及FEF_(75%)均显著低于正常BMI组和低BMI组(均P<0.05),FVC%预计值显著低于正常BMI组(P<0.05),FEV_(1)%预计值增加百分数显著低于低BMI组(P<0.05);正常BMI组FVC%预计值显著高于低BMI组(P<0.05)。男性患者BMI与FEV_(1)增加绝对值呈负相关(r=-0.148,P<0.05);女性患者BMI与FEV_(1)%预计值、FEV_(1)/FVC、MMEF、FEF_(25%)、FEF_(50%)、FEF_(75%)及FEV_(1)%预计值增加百分数均呈负相关(r=-0.124、-0.127、-0.165、-0.138、-0.156、-0.162、-0.106,均P<0.05)。结论哮喘患者BMI与肺功能显著相关,高BMI患者肺功能相对更差;且在女性患者中,BMI对肺功能的影响更显著;BMI升高可致肺功能及气道可逆性下降,提示在哮喘管理中应重视BMI的管理。Objective To analyze the correlation between body mass index(BMI)and lung function in patients with bronchial asthma(asthma).Methods This study was a retrospective study.A total of 828 patients with asthma were included from March 2013 to November 2022 in the first affiliated Hospital of Guangxi Medical University,including 292 males and 536 females,aged 21-82 years,with a median age of 47 years.According to BMI,these asthma patients were divided into high BMI group(BMI≥24 kg/m^(2)),normal BMI group(18.5 kg/m^(2)≤BMI<24 kg/m^(2))and low BMI group(BMI<18.5 kg/m^(2)).Forced vital capacity(FVC),forced expiratory volume in first second(FEV_(1)),FEV_(1)/FVC,maximum mid-expiratory flow(MMEF),forced expiratory flow at 25%,50%and 75%of FVC(FEF_(25%),FEF_(50%),FEF_(75%)),peak expiratory flow(PEF),absolute increases in measured values of FVC and FEV_(1) and percentage increases in FVC%pred(“%pred”represents the percentage of related indicators to expected value)and FEV_(1)%pred after inhalation of bronchodilator(salbutamol)were measured by pulmonary function meter.The correlation between BMI and the above indexes was analyzed.Results In the high BMI group,FEV_(1)%pred,MMEF,FEF_(25%),FEF_(50%)and FEF_(75%)were significantly lower than those in the normal BMI group and the low BMI group(all P<0.05),FVC%pred was significantly lower than those in the normal BMI group(P<0.05),and the percentage increase of FEV_(1)%pred was significantly lower than those in low BMI group(P<0.05).FVC%pred in the normal BMI group was significantly higher than that in the low BMI group(P<0.05).In male patients,BMI was negatively correlated with the absolute increase of FEV_(1)(r=-0.148,P<0.05);In female patients,BMI was negatively correlated with FEV_(1)%,FEV_(1)/FVC,MMEF,FEF_(25%),FEF_(50%),FEF_(75%)and the percentage increase of FEV_(1)%pred(r=-0.124,-0.127,-0.165,-0.138,-0.156,-0.162,-0.106,all P<0.05).Conclusion There is a significant correlation between BMI and lung function in patients with asthma,and the lung function in patients wit

关 键 词：哮喘 体重指数 肺功能 患者管理 

分 类 号：R562.25[医药卫生—呼吸系统]