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1.
目的探讨肥胖是否与气道反应性增高有关及是否存在性别差异。方法选择中南大学湘雅二医院肺功能室2003年1月至2006年6月激发试验阳性的气道高反应性患者1180例,分析其体重指数(BMI)与肺功能的相关性;与吸入药物后第一秒用力呼气容积(FEV1)下降百分率达对照值20%时的药物浓度(PC20FEV1)的相关性;并进一步分析男、女患者BMI与PC20FEV1的相关性。结果BMI与用力肺活量(FVC)、FEV1、PC20FEV1均呈负相关(r分别为-0.735,-0.645和-0.044,P均(0.05)。男性患者BMI与PC20FEV1无相关性(P(0.05),女性患者BMI与PC20FEV1呈负相关(r=-0.044,P(0.05)。结论肥胖与肺功能降低及气道反应性增高可能相关,这种影响在女性患者中更明显。成年女性气道反应性较成年男性高。  相似文献   

2.
秦慧  陈燕  王群 《临床内科杂志》2011,28(2):122-124
目的 探讨在肺功能测定中能否用第1秒用力呼气量与6秒用力呼气量比值(FEV1/FEV6)代替第1秒用力呼气量与肺活量比值(FEV1/FVc)的可行性.方法 对256名慢性阻塞性肺病(COPD)患者和174名非COPD患者进行肺功能检测,收集FVC、FEV6、FEV1/FVC、FEV1/FEV6等数据.比较FEV6与FVC以及FEV1/FEV6与FEV1/FVC的相关性;并以FEV1/FVC〈70%作为判断气流阻塞的标准,计算相应FEV1/FEV6检测气流阻塞的敏感性和特异性.结果 (1)FEV6与FVC以及FEV1/FEV6与FEV1/FVC均呈强正相关关系;(2)根据ROC曲线结果,取FEV1/FEV6为〈72.6%,其诊断气流阻塞的敏感性和特异性分别达到97.7%和98.4%.结论 FEV1/FEV6能够代替FEV1/FVC检测气流阻塞。  相似文献   

3.
目的探讨不同型号肺功能仪对同一人群测试指标的可比性。方法用美国PDS公司KOKO台式肺功能仪和日本M INATO公司SYSTEM7型肺功能仪分别对同一人群进行肺通气功能测试,并对其指标进行比较分析。结果两种仪器的肺活量(VC)、肺活量预计值(VC预计值)、VC/VC预计值%、用力肺活量(FVC)、用力肺活量预计值(FVC预计值)、FVC/FVC预计值%、第一秒用力肺活量(FEV1)差异无显著性(P〉0.05),但SYSTEM7型肺功能仪的FEV1预计值、比KOKO台式肺功能仪的高,差异显著(P〈0.05),SYSTEM7型肺功能仪的FEV1/FEV1预计%比KOKO台式肺功能仪的低,差异显著(P〈0.05)。结论两种不同型号的肺功能仪实测值VC、FVC、FEV1可以互认,但由FEV1预计值不一,可能致使实测值/预计值百分比不一,影响肺功能诊断,对不同仪器采用的预计值模式的适应性首先要进行评价。  相似文献   

4.
目的探讨稳定期不同级别COPD患者血清中氧化/抗氧化因子及细胞炎症因子水平与肺功能主要指标的关系。方法选取COPD稳定期患者80例,检测各患者肺功能与血清中反应性氧核素(ROS)、超氧化物歧化酶(SOD)及细胞炎症因子水平,观测各组的差异并分析其相关性。结果FEV1、FVC、FEV1/FVC、SOD、ROS、TNF.d、IL-8、GM—CSF水平在不同组别中存在差异(P〈0.05),ROS、TNF-a、IL-8、GM—CSF水平与FEV1,FVC、FEV1/FVC存在着明显的负相关(P〈0.05),SOD与其存在明显正相关(P〈0.05)。结论COPD细胞炎症因子的持续升高及氧化加重可能是引起稳定期COPD肺组织慢性损伤、功能降低的重要机制。  相似文献   

5.
目的探讨机械通气时呼吸力学与术前肺功能的关系.确定术前通气功能参数能否预测术后呼吸衰竭。方法择期行肺切除术的原发性肺癌病人100例.ASAⅠ级或Ⅱ级,术前测定肺功能:一秒用力呼气容量(FEV1)、用力肺活量(FVC)、一秒用力呼气量与用力肺活量之比(FEV1/FVC%)、最大肺活量(VC)、最大通气量(MVV)、75%肺活量位用力呼气流速(FEh)、最大中期呼气流速(MMEFm)、功能残气量(FRC)、残气量与肺总量之比(RV/TLC%);测定脉冲震荡肺功能:共振频率(Fres)、呼吸总阻抗(Zres)、中心阻力(Rc)、5Hz和20Hz时粘性阻力(R5、R30)。分别记录插管后机械通气初始和开胸单肺通气后双肺气道峰压(Tpeak)、双肺胸肺顺应性(TCT)和单肺气道峰压(Opeak)、单肺胸肺顺应性(OCT),取其平均值。Opeak和OCT与身高、体重及肺功能的关系采用多元逐步回归。一般情况和肺功能与术后呼吸衰竭的关系采用非条件Logistic回归分析。根据术后是否发生呼吸衰竭分为2组:呼吸衰竭组(RF)和非呼吸衰竭组(NRF)。结果Opeak与Zres、身高、体重和FEF。呈线性关系(R2=0.504),OCT与Zres、身高、VC和RVfrLC%呈线性关系(R^2=0.602)。与NRF组比较,RF组FEV1、FVC、FEV1/FVC%、MVV、MMEFw均降低(P〈0.01)。年龄≥60岁的老年患者FEV1≤60%、FEV1/FVC≤60%、MVV≤50%、MMEn%≤35%时,RF组术后呼吸衰竭发生率高于NRF组(P〈0.05)。Logistic回归表明.年龄和MVV是术后呼吸衰竭的两个主要影响因素。结论术中单肺通气时的气道峰压和胸肺顺应性分别与身高、体重和术前肺功能呈线性相关。中度肺功能减退的老年患者行胸科手术后发生呼吸衰竭的风险性大:年龄和MVV是术后呼吸衰竭的两个主要影响因素。  相似文献   

6.
目的研究T2DM患者的肺功能损害及其影响因素。方法选取我院100例诊断为T2DM的患者及40名健康志愿者,检测肺功能及动脉血气进行对照研究,并以肺功能各项指标与FPG、胰岛素敏感性指数(ISI)、HbA1c、BMI和糖尿病病程等进行多因素线性回归分析。结果(1)T2DM组BMI明显高于对照组(P〈0.01)。(2)T2DM组肺总量(TLC)、用力肺活量(FVC)、1秒用力呼气量(FEV1)、用力呼出气量为50%肺活量的最大呼气中期流量(MMEF50)、用力呼出气量为25%肺活量的最大呼气中期流量(MMEF25)明显低于对照组(P〈0.01)。T2DM组一氧化碳弥散量(DLCO)、弥散指数(DLCO/VA)、动脉血氧分压(PaO2)和血氧饱和度(SaO2)低于对照组(P〈0.01)。(3)TLC、FVC、FEV1、MMEF50与FPG、2hPG、FC-P、2hC-P、HbA1c、BMI、ISI、病程无明显相关;但DL(如、DLCO/VA、MMEF25与FPG、2hPG、FC-P、2hC-P、HbA1c、BMI、病程呈显著负相关(P〈0.05或P〈0.01),与ISI呈显著正相关(P〈0.05)。结论(1)T2DM患者肺功能损害主要表现为限制性通气功能障碍、小气道功能减退和弥散功能异常。(2)FPG、2hPG、FC-P、2hC-P、HbA1c、BMI、病程、ISI与T2DM小气道损害和肺弥散功能障碍密切相关。  相似文献   

7.
目的:探究慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前后肺功能、全身性炎症反应综合征(SIRS)评分、血清炎症因子水平变化及其预后的相关性。方法:通过肺功能检测仪检测109例AECOPD患者治疗前后肺功能指标[第1秒用力呼气容量占用力肺活量比值(FEV1/FVC)、FEV1占预计值百分比(FEV1%)],酶联免疫吸附法(ELISA)测定血清炎症因子[白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT]指标。对AECOPD患者治疗前后行SIRS评分,并分析上述指标与患者预后的相关性。结果:患者治疗后FEV1/FVC、FEV1%较治疗前均显著上升,IL-6、IL-8、TNF-α、PCT水平、SIRS评分显著下降,差异有统计学意义(P0.05);AECOPD存活组患者入院时FEV1/FVC、FEV1%水平均显著高于死亡组,血清IL-6、IL-8、TNF-α、PCT水平、SIRS评分均显著低于死亡组,差异有统计学意义(P0.05);FEV1/FVC、FEV1%与患者预后正相关(P0.05),IL-8、TNF-α、SIRS评分与预后负相关(P0.05)。结论:肺功能、血清炎症因子、SIRS评分对AECOPD诊断、疗效判断有重要意义,肺功能下降、IL-8、TNF-α水平上升、SIRS评分高为患者死亡的危险因素。  相似文献   

8.
张雪岩 《山东医药》2011,51(43):69-70
目的探讨慢性阻塞性肺疾病(COPD)患者静息肺功能、运动耐力变化及两者的关系。方法选择32例稳定期COPD患者(COPD组)和20例健康体检者(对照组),分别行静息肺功能测定和症状自限最大运动负荷递增试验,记录用力肺活量(FVC)、第1秒用力肺活量(FEV1.0)、FEV1.0占预计值百分比(FEV1.0%)、最大通气量(MVV)、静息状态下一氧化碳弥散量(DLCO)和最大摄氧量(VO2 max);对COPD静息肺功能指标与VO2 max的关系行直线相关分析。结果COPD组FVC、FEV1.0、FEV1.O%、FEV1.0/FVC、MVV、DLCO和VO2 max均显著低于对照组(P均〈0.05);COPD组FVC、FEV1.0、FEV1.0%、FEV1.0/FVC、MVV和DLCO与VO2 max均呈显著正相关(P均〈0.05)。结论稳定期COPD患者静息肺功能及运动耐力均有所减退,且两者呈正相关;联合检测此两项指标可综合评价COPD病情进展、预后及指导康复治疗。  相似文献   

9.
目的 研究COPD患者体重指数(BMI)与肺功能指标的相关性,为COPD患者治疗护理提供新的依据.方法 随机选取2010年1月至2011年10月来我院呼吸内科就诊的男性COPD患者115例,按BMI分成三组:低BMI组50例,正常BMI组50例,超BMI组15例,检测肺功能指标:深吸气量(IC)、第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、一秒率(FEV1/FVC).结果 超BMI组IC、FEV1、FVC比正常BMI组明显增高(P<0.05),正常BMI组IC、FEV1、FVC又比低BMI组明显增高(P<0.05),三组FEV1/FVC无明显差异(P>0.05).相关性分析提示BMI与IC、FEV1、FVC呈正相关,与FEV1/FVC无相关性.结论 改善COPD患者营养状况,控制理想的体重指数,可以有效地改善肺功能,提高生活质量.  相似文献   

10.
目的通过肺癌患者放疗前后肺功能检测来评价其临床意义。方法放疗前一周及放疗后1个月和3个月分别检测肺功能,指标包括:用力肺活量(FVC)、一秒内用力呼气量(FEV1)、肺一氧化碳弥散量(DLCO)。结果放疗后1月,在基础肺功能正常组,FVC,FEV,值明显高于放疗前,而DLCO值有下降趋势(P〉0.05);在基础肺功能异常组,FVC,FEV1,DLCO值均有下降趋势(P〉0.05)。放疗后3个月时,在基础肺功能正常组,FVC,FEV1值较放疗前有下降,但无统计学差异,而DLCO下降明显。在基础肺功能异常组,FVC,FEV1,DLCO均较放疗前下降明显,有统计学差异。结论放疗能导致肺功能损伤,基础肺功能异常的患者做放疗计划时可能需要适当地减少放疗剂量。  相似文献   

11.
Objective: This study was to investigate whether the metabolic abnormalities of adipokines and asymmetrical dimethylarginine (ADMA) associate with pulmonary function deficits in adolescents with obesity and asthma. Methods: This study enrolled 28 obese adolescents with asthma, 46 obese adolescents without asthma, 58 normal-weight adolescents with asthma, and 63 healthy control subjects. Serum levels of leptin, high-molecule-weight (HMW) adiponectin, retinol binding protein 4 (RBP4), asymmetrical dimethylarginine (ADMA), and pulmonary function were qualified. Results: The obese subjects had higher levels of leptin and ADMA but lower levels of HMW adiponectin than the normal-weight subjects with or without asthma. The subjects with asthma had higher levels of RBP4 than those without asthma. The obese adolescents with asthma had lowest forced expiratory lung volume in the first second (FEV1)/forced vital capacity (FVC) ratio among the four study groups. In all the study subjects and in the subjects with asthma alone, the FEV1/FVC ratio associated negatively with leptin, however, such association was rendered non-significant when adjusted for BMI. The pulmonary function deficits associated inversely with BMI percentile in the subjects with asthma. However, the decreased FEV1/FVC ratio was not correlated with HMW adiponectin, RBP4 or ADMA. Conclusions: Our present study confirmed obstructive pattern of pulmonary function characterized by the reduced FEV1/FVC ratio in the obese adolescents with asthma. These pulmonary deficits were associated inversely with the increased BMI percentile.  相似文献   

12.
OBJECTIVE: Obesity is linked to the insulin resistance syndrome (IRS), type 2 diabetes (T2D) and cardiovascular disease. Markers of chronic subclinical inflammation such as high-sensitive C-reactive protein (hs-CRP) and interleukin 6 (IL-6) are closely related to insulin resistance and obesity. Recent evidence suggests that adiponectin, a protein whose circulating levels are decreased in obesity, has anti-inflammatory properties, and also appears to enhance potently insulin action and therefore appears to function as a signal produced by adipose tissue that influences whole-body glucose metabolism. SUBJECTS AND METHODS: We investigated the cross-sectional and longitudinal association of adiponectin with CRP and IL-6 in 41 morbidly obese women with different stages of glucose tolerance before and 17 months after significant weight loss induced by gastric surgery. Adiponectin was measured by RIA. CRP and IL-6 were determined by commercially available ELISA systems. RESULTS: Weight loss induced a significant shift from T2D (preoperatively 34% vs postoperatively 2%) to impaired glucose tolerance (IGT) (37% preoperatively vs 30% postoperatively) and normal glucose tolerance (NGT) (29% preoperatively vs 68% postoperatively). Preoperatively adiponectin levels were negatively correlated with CRP (r=-0.59, P<0.0006), IL-6 (r=-0.42, P<0.02) and leukocytes (r=-0.41, P<0.007). After gastroplasty, adiponectin concentrations increased significantly (15.4+/-8.2 vs 19.8+/-6.2 microg/ml, P<0.005) associated with changes of weight and body mass index (r=-0.45, P<0.007; r=-0.35, P<0.04). Furthermore, preoperative CRP was significantly associated with changes in adiponectin even after adjustment for sex, age, preoperative body mass index (BMI) impaired glucose metabolism and changes in BMI and changes in BMI (standardized beta 0.61, P=0.005). CONCLUSION: Levels of adiponectin, which are associated with markers of chronic subclinical inflammation, could be significantly increased after weight loss in morbidly obese patients. This increase was more pronounced in patients with NGT compared to those with T2D and IGT. Preoperative levels of CRP are predictive for changes of adiponectin after weight loss.  相似文献   

13.
Pulmonary function and abdominal adiposity in the general population   总被引:2,自引:0,他引:2  
BACKGROUND: The prevalence of obesity is increasing, and there is evidence that obesity, in particular abdominal obesity as a marker of insulin resistance, is negatively associated with pulmonary function. The mechanism for this association and the best marker of abdominal adiposity in relation to pulmonary function is not known. STUDY OBJECTIVE: We assessed the association between pulmonary function and weight, body mass index (BMI), waist circumference, waist/hip ratio, and abdominal height as markers of adiposity and body fat distribution. We used multiple linear regression to analyze the association of pulmonary function (ie, FEV(1) and FVC) [with maneuvers performed in the sitting position] with overall adiposity markers (ie, weight and BMI) and abdominal adiposity markers, stratified by gender, and adjusted for height, age, race, smoking, and other covariates.Setting and participants: A random sample of individuals (n = 2,153) from the general population living in western New York state, 35 to 79 years of age. RESULTS: In women, abdominal height and waist circumference were negatively associated with FEV(1) percent predicted, while all five adiposity markers were negatively associated with FVC percent predicted. In men, all overall and abdominal adiposity markers were inversely associated with FEV(1) percent predicted and FVC percent predicted. CONCLUSION: These results suggest that abdominal adiposity is a better predictor of pulmonary function than weight or BMI, and investigators should consider it when investigating the determinants of pulmonary function.  相似文献   

14.
STUDY OBJECTIVES: To test if morbid obesity causes pulmonary function changes and if massive weight loss have effect on pulmonary function (especially in subjects with BMI>or=60 kg/m(2)). PARTICIPANTS: Thirty-nine morbid obese subjects before and after massive weight loss. MEASUREMENTS AND RESULTS: Patients had baseline BMI>or=40 kg/m(2), pulmonary function test (PFT) before and after surgery for gastric volume reduction and massive weight loss, and presented no complaints unrelated to obesity. Based on initial BMI, the patients were divided in groups A (BMI 40-59.9 kg/m(2)) and B (BMI>or=60 kg/m(2)). Initially, group A (n=28) had normal PFT, however group B (n=11) presented FVC and FEV(1) measurements in the lowest limit of normality (with normal FEV(1)/FVC), significantly different from group A. After massive weight loss, the group B compared to A had a significant improvement in FVC (23.7% vs. 9.7%, P=0.012) and FEV(1) (25.6% vs. 9.1%, P=0.006); thus the initial difference in FVC and FEV(1) between groups no longer existed after weight loss. CONCLUSIONS: These results point out that the severe morbid obesity (BMI>or=60 kg/m(2)) may lead to pulmonary function impairment and presents more prominent pulmonary function gain after massive weight reduction. The possible clinical implications of these results are that PFT abnormalities in subjects with BMI<60 kg/m(2) should probably be interpreted as consequence of intrinsic respiratory disease and that severe morbid obese patients may be encouraged to lose weight to improve their pulmonary function, especially those with concomitant pulmonary disorders.  相似文献   

15.
目的探讨肠内营养对老年慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)患者心肺功能的影响。方法选择老年COPD稳定期患者58例,常规治疗基础上随机分为2组,其中治疗组29例(肠内营养),对照组29例(自由饮食)。治疗前后检测各项营养指标(血清总蛋白、白蛋白、前白蛋白)、LVEF、肺功能[第一秒用力呼气容积(FEV1),用力肺活量(FVC)]。结果治疗组治疗后体质量指数、血清总蛋白、白蛋白、前白蛋白水平较治疗前明显升高,而对照组以上各项指标改善不明显。治疗组治疗后体质量指数、血清总蛋白、白蛋白、前白蛋白水平较对照组明显改善,差异有统计学意义(P<0.05)。治疗组治疗后LVEF[(48.98±6.38)%vs(42.38±5.98)%,(42.73±5.34)%]、FVC[(2.98±0.38)Lvs(2.75±0.31)L,(2.76±0.34)L]、FEV1[(2.06±0.87)Lvs(1.78±0.72)L,(1.92±0.90)L]、FEV1/FVC[(78.36±12.32)vs(70.65±12.28),(71.23±12.55)]较治疗前和对照组明显改善,差异有统计学意义(P<0.05)。结论老年COPD患者,在常规治疗的同时给予肠内营养治疗,可以改善患者营养状况,进一步改善患者心肺功能,缩短住院时间。  相似文献   

16.
IntroductionAsthma is one of the diseases which has a high prevalence in developed and developing countries. The relationship between asthma and obesity has always been focused by researchers. In this field, adipokines, especially adiponectin and leptin have highly attended by the scientist. The aim of this study was to determine the serum level of adiponectin, leptin and the leptin/adiponectin ratio in asthmatic patients and its relationship with disease severity, lung function and BMI (body mass index).MethodsIn this cross-sectional study, 90 asthmatic women admitted to the tertiary referral hospital in Kurdistan province – Iran, were examined. First, BMI was measured and then pulmonary function tests were performed in all asthmatics patient. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC, were measured. At the end, blood samples were collected and serum level of adiponectin and leptin were measured by ELISA method.ResultSerum leptin and leptin/adiponectin levels correlated positively with asthma severity and BMI (p = 0.0001), but there was no correlation between adiponectin level with asthma severity and BMI (p > 0.05), also serum leptin and leptin/adiponectin levels inversely correlated with FEV1 and FVC in patient (p = 0.0001).ConclusionAsthma is linked with obesity, and there is an association between asthma severity and BMI with serum leptin and leptin/adiponectin levels, but our results do not support a significant role of adiponectin in obesity or asthma.  相似文献   

17.
目的探讨COPD患者进行6分钟步行试验(6MWT)前后血气变化及其与肺功能的关系。方法选择46例COPD患者,另选经肺功能检查证实肺功能正常的43名其他患者作为对照组,进行6分钟步行试验,试验前后记录患者的血压、心率及呼吸频率,采用美国GEMPremier3000型血气分析仪测定血气结果,所有患者均测定肺功能。结果试验组和对照组在6分钟步行试验距离、动脉血氧饱和度下降分数、血乳酸浓度方面,差异均具有显著性,6分钟步行距离同FEV1、FEV1/FVC正相关,动脉血氧饱和度下降分数同FEV1、FEV1/FVC比值呈明显负相关(P〈0.05)。结论 6分钟步行试验能对COPD患者的肺功能及全身功能状态进行评估,价格低廉,方便,更适合在基层医疗单位推广。  相似文献   

18.
目的通过检测稳定期不同级别慢性阻塞性肺疾病患者血清中氧化/抗氧化指标及细胞炎症因子水平与肺功能主要指标的关系,探讨血清氧化/抗氧化因子及细胞炎症因子水平的变化对肺功能的影响,从而明确COPD稳定期慢性肺损伤的机制。方法在呼吸科门诊筛查的COPD稳定期患者中选取80例,按照2011年《慢性阻塞性肺疾病诊治指南》标准分级,分成4组:Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组。检测用力肺活量(FVC)、1秒钟用力呼气容积(FEV1)、FEV1/FVC;用ELISA方法测定患者血清中氧化指标反应性氧核素(ROS)、氧化/抗氧化指标超氧化物歧化酶(SOD)及细胞炎症因子中的肿瘤坏死因子-α(TNF-α)、IL-8及粒-巨细胞集落刺激因子(GM-CSF)水平,观测各组的差异并分析其相关性。结果 FEV1、FVC、FEV1/FVC、SOD、ROS、TNF-α、IL-8、GM-CSF水平在不同组别中存在差异(P<0.05),且ROS、TNF-α、IL-8、GM-CSF水平与FEV1,FVC存在着明显的负相关(P<0.05),然而SOD与其存在明显正相关(P<0.05)。结论 COPD细胞炎症因子的持续升高及氧化加重可能是引起稳定期慢性阻塞性肺疾病肺组织慢性损伤、功能降低的重要原因。  相似文献   

19.
目的了解低体重、正常体重、超重、肥胖和严重肥胖者肺通气功能差异,探讨体重指数对肺通气功能参数的影响。方法对研究对象进行年龄、性别、身高、体重、腰围、臀围记录,采用亚洲成人体重分级建议的肥胖、超重诊断标准,将研究对象分为体重过低、正常体重、超重、肥胖和严重肥胖5组,经X线检查排除有明显肺部疾病者进行体重指数和通气功能指数测定,正常体重与低体重、超重、肥胖者肺通气功能均数比较。结果体重过低、超重、肥胖和一类重肥胖组的用力呼气量(FVC)、第一秒用力呼气量(FEV1.0)、一秒率(FEV1.0/FVC)、用力呼气中期流速(FEF0.25~0.75)、肺活量(VC)、最大通气量(MVV)测量值和正常体重组作比较,结果有统计学意义。6指标在男女内部比较,男性在FEV1.0和VC方面差异有统计学意义(F=5.02,P=0.025;F=5.31,P=0.021);女性内部方差分析MVV在正常体重与超重肥胖组比较(P〈0.05)。结论与对照组比较,肥胖、超重通气功能有一定影响,体重过低也对肺通气功能有影响。  相似文献   

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