儿童阻塞性通气功能障碍判断参数的临床分析
收稿日期: 2023-03-13
网络出版日期: 2023-05-10
Clinical analysis of the criteria of obstructive ventilation dysfunction in children in Shanghai
Received date: 2023-03-13
Online published: 2023-05-10
目的 对儿童阻塞性通气功能障碍的相关肺功能参数进行临床合理性分析。方法 选取2021年1月至12月在呼吸科就诊并完成肺功能检查的6~18岁患儿,以1岁为年龄间隔分组。检测用力肺活量(FVC)、最大肺活量(VCmax)、第1秒用力呼气容积(FEV1)、FEV1/FVC、FEV1/VCmax等肺功能参数,分析FEV1/FVC实测值和实测值/预计值、FEV1/VCmax实测值和实测值/预计值分别在临床判读阻塞性通气功能障碍时的一致情况。结果 纳入儿童7 025例,男4 543例、女2 482例,平均年龄(8.6±2.5)岁,以6~10岁儿童为最多,共4 769例(67.9%)。除10~11岁、11~12岁组不同性别间的FEV1差异无统计学意义(P>0.05)以外,其他年龄组不同性别间FEV1、FVC、VCmax差异均有统计学意义(P<0.05),FEV1、FVC、VCmax均为男性大于女性。除15~16岁、16~17岁组以外,其他各年龄组不同性别之间FEV1/FVC实测值和实测值/预计值差异均有统计学意义(P<0.05);除13~14岁、16~17岁组以外,其他各年龄组不同性别之间FEV1/VCmax实测值和实测值/预计值差异均有统计学意义(P<0.05),女性FEV1/FVC、FEV1/VCmax的实测值和实测值/预计值均高于男性。FEV1/FVC实测值<80%和FEV1/FVC实测值/预计值<92%的判读不一致率为6.8%,FEV1/FVC实测值和FEV1/VCmax实测值判读不一致率为5.0%,最终得出理想的FEV1/VCmax实测值/预计值为93.9%。结论 建议FEV1/VCmax的实测值/预计值<93.9%可作为判读儿童阻塞性通气功能障碍的临床参考标准。
邬宇芬 , 董文芳 , 潘春红 , 张皓 . 儿童阻塞性通气功能障碍判断参数的临床分析[J]. 临床儿科杂志, 2023 , 41(5) : 339 -345 . DOI: 10.12372/jcp.2023.23e0183
Objective To analyze the clinical rationality of pulmonary function parameters associated with obstructive ventilation dysfunction in children. Methods Children aged 6-18 years who attended the respiratory department and completed pulmonary function tests from January to December 2021 were selected and grouped at an age interval of one year. The relevant lung function parameters such as forced vital capacity (FVC), maximum vital capacity (VCmax), forced expiratory volume in the first second (FEV1), FEV1/FVC, FEV1/VCmax were detected. The clinical consistency between measured and measured/predicted value of FEV1/FVC, measured and measured/predicted value of FEV1/VCmax, respectively, in the interpretation of obstructive lesions was compared. Results A total of 7025 children were enrolled, including 4543 males and 2482 females with median age of (8.6±2.5) years old, with the largest number of children aged 6-10 years old. Except for 10-11 and 11-12 age group, the volume correlation parameters FVC, VCmax and FEV1 were greater in males than in females, and their absolute values increased with the increase of age. There was a slight difference between VCmax and FVC in all age groups, and VCmax was slightly higher than FVC. The measured and predicted values of FEV1/FVC in females were higher than those in males except 15-16 and 16-17 age group. The measured and predicted values of FEV1/VCmax for females were higher than those for males except for 13-14 and 16-17 age group. When the measured value of FEV1/FVC < 80% and the measured/predicted value of FEV1/FVC < 92%, the interpretation inconsistency rate is 6.8%, and the interpretation inconsistency rate between the measured value of FEV1/FVC and the measured value of FEV1/VCmax is 5.0%. Finally, the ideal FEV1/VCmax measured/predicted value is 93.9%. Conclusions The measured/predicted value of FEV1/VCmax <93.9% can be used as a clinical reference standard for the interpretation of obstructive ventilation dysfunction in children.
Key words: asthma; obstructive ventilation dysfunction; vital capacity; child
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