东北地区8～10岁儿童肺功能参考值预测方程研究

目的通过调查我国东北地区8~10岁城市儿童肺功能,探讨建立肺功能参考值预测方程。方法2015年7-12月,在我国东北地区的黑龙江、吉林、辽宁的三个中心城市(A,B,C市)采用多阶段典型抽样和随机整群抽样相结合的方法,对868名8~10岁健康小学生进行问卷调查,并检测用力肺活量(FVC)、1秒用力呼气量(FEV1)、呼气峰值流速(PEF)、25%FVC时的用力呼气流量(V25)和75%FVC时的用力呼气流量(V75)五项肺功能指标;以各项指标为因变量,性别、年龄、身高、体重为自变量,采用多重线性回归模型建立各指标参考值预测方程,利用2014年B市142名儿童的实际调查数据,对建立的方程进行验证,计算模型预测值和实测值的差异度差异度(%)=(预测值-实测值)/实测值×100%],评价预测模型的适用性。结果各肺功能指标随年龄的增加而增加,同年龄组中男生各肺功能指标均值整体高于女生。男女生肺功能与年龄(x1)、身高(x2)、体重(x3)均成正相关,男生各指标参考值的预测方程为,FVC=-1.555+0.125x1+0.012x2+0.011x3,FEV1=-0.922+0.114x1+0.008x2+0.008x3,PEF=-0.687+0.34x1+0.014x3,V25=1.855+0.008x3,V75=-3.243+0.342x1+0.019x3。女生各指标参考值的预测方程为,FVC=-1.444+0.137x1+0.01x2+0.011x3,FEV1=-1.169+0.142x1+0.007x2+0.009x3,PEF=-0.981+0.346x1+0.012x3,V25=0.966+0.101x1+0.01x3,V75=-1.539+0.383x1+0.011x3。男生PEF、V75,女生FEV1、PEF、V75预测值和实测值差异无统计学意义(P>0.05),差异度在-7%~4%之间。男生FVC、FEV1,女生FVC预测值低于实测值(P<0.05),差异度在-13%^-8%之间。男女生V25预测值高于实测值(P<0.05),差异度在13%~26%之间。结论利用多重线性回归模型建立的我国东北地区8~10岁城市儿童肺功能参考值预测方程,对男生PEF、V75,女生FEV1、PEF、V75预测效果较好,对男生FVC、FEV1、V25,女生FVC、V25的预测值与实测值存在差异。

Prediction equation of reference value for lung function of children aged 8-10 in northeast China

Objective To establish prediction equation of the reference value for lung function,by investigating the lung function of children aged 8-10 in northeast China.Methods During July- December,2015,in city A,B,C,the central cities of Heilongjiang,Jilin and Liaoning provinces in northeast China,868 healthy pupils aged 8-10,were chosen by using the typical and random cluster sampling method,spirometric values including forced vital capacity (FVC),forced expiratory volume in one second (FEV1),peak expiratory flow rate (PEF) and 25%FVC of the forced expiratory flow (V25) and 75%FVC of the forced expiratory flow(V75) were measured after conducting a questionnaire survey.The prediction equations were derived by using multiple linear regression,the dependent variables were the spirometric values and the independent variables were age (x1), height(x2) and weight(x3).A total of 142 children's spirometric values which were measured in 2014 in city B were used to evaluate the results of models and the differences between the measured values and predicted values were calculateddifference degree(%)=(measured values-predicted values)/measured values×100%].Results Spirometric values increased with the age, and revealed higher levels in boys compared with those in girls with the same age.Spirometric values were positively correlated with age,height and weight.The prediction equations for boys were fitted as follows,FVC=-1.555+0.125 x1+0.012 x2+0.011 x3, FEV1=-0.922+0.114 x1+0.008 x2+0.008 x3,PEF=-0.687+0.34 x1+0.014 x3,V25=1.855+0.008 x3,V75=-3.243+0.342 x1+0.019 x2;For girls,FVC=-1.444+0.137 x1+0.01 x2+0.011 x3,FEV1=-1.169+0.142 A+0.007 x2+0.009 x3,PEF=-0.981+0.346 x1+0.012 x3, V25=0.966+0.101 x1+0.01 x3,V75=-1.539+0.383 x1+0.011 x3.There was no significant difference in PEF,V75 of boys and FEV1, PEF,V75 of girls between the measured values and predicted values (P>0.05),the difference degrees were -7%-4%;The predicted values of FVC,FEV1 of boys and FVC of girls were lower than measured values(P<0.05),the difference degrees were -13%--8%;The predicted values of V25 both in boys and girls were higher than measured values (P<0.05),the difference degrees were 13%-26%.Conclusion The prediction equations of reference values for lung function of children aged 8-10 in northeast China have been established in the present study.They can make good predictions for PEF,V75 in boys and FEV1, PEF,V75 in girls,but the differences in FVC,FEV1,V25 for boys and FVC,V25 for girls between predicted values and measured values exist.