全球肺功能倡议预计值对济南市老年人的适用性检验

doi:10.6040/j.issn.1671-7554.0.2018.141

摘要/Abstract

摘要： 目的检验全球肺功能倡议(GLI)-2012版肺通气功能预计值对济南市老年人的适用性。方法招募无吸烟史、60~84周岁的健康老年人,进行肺通气功能检查,记录用力肺活量(FVC)、第一秒用力呼气容积(FEV₁)、FEV₁/FVC、最大呼气中期流量(MMEF)。以GLI-2012版预计值为依据,计算各参数Z分数。配对t检验分别比较GLI-2012版均值的预计值与实测值、GLI-2012版正常值下限(LLN)预计值与华东地区即中山-2011版LLN。结果研究纳入438例受试者,男210例,女228例。FVC、FEV₁、FEV₁/FVC和MMEF在男性中的Z分数分别为0.23±1.34、0.27±1.31、0.03±0.71、-0.03±0.94,在女性中的Z分数分别为0.22±0.95、0.08±0.89、-0.28±0.65、-0.14±0.90。GLI-2012版均值预计值与实测值吻合良好,但对FEV₁/FVC的LLN预计值显著低于中山-2011版,男性LLN均差的95%CI为(-5.79~-5.55)%(t =-91.310,P<0.001)。以GLI-2012版LLN为标准时,阻塞的检出率与(-overx)-3s标准相近(0.9% vs 0.7%)。结论尽管GLI-2012版对肺通气功能参数均值的预计值适用于济南市老年人,但对LLN的预计值偏低,易致老年人阻塞性肺通气功能障碍诊断不足。

关键词: 肺功能检查, 肺通气功能, 预计值, 全球肺功能倡议, 老年人

Abstract: Objective To validate the applicability of Global Lung Function Initiative(GLI)-2012 reference values for spirometry to elderly Chinese in Jinan City. Methods Healthy people aged 60-84 without smoking history were recruited and underwent spirometry. FVC(forced vital capacity), FEV₁(forced expiratory volume in one second),FEV₁/FVC, and MMEF(maximal midexpiratory flow)were recorded. Z-scores were computed according to the GLI-2012 reference values. Comparisons of GLI-2012 predicted values and observed values, and lower limit of normal(LLN)computed using GLI-2012 and Zhongshan-2011 equations were performed by paired t test. Results A total of 438 subjects(228 females, 210 males)were completely qualified. The Z-scores of FVC, FEV₁, FEV₁/FVC and MMEF for males were 0.23±1.34, 0.27±1.31, 0.03±0.71, -0.03±0.94, and for females were 0.22±0.95, 0.08±0.89, -0.28±0.65, -0.14±0.90. The predicted mean values of GLI-2012 were in good agreement with observed values. However, the LLN of FEV₁/FVC predicted by GLI-2012 equations was lower than that by Zhongshan-2011. The 95%CI of mean difference for males was(-5.79—-5.55)%(t=-91.310, P<0.001). The proportion of abnormal FEV₁/FVC in the sample was 0.9% in terms of the GLI-2012 LLN, which was similar to the proportion when using(-overx)-3s as the cut off 山东大学学报 (医学版)56卷7期 -刘春红,等. 全球肺功能倡议预计值对济南市老年人的适用性检验 \=-value(0.7%). Conclusion The GLI-2012 predicted mean values for spirometry are appropriate for the elderly in Jinan City, but it underestimates the LLN and may lead to the missed diagnosis of obstructive ventilatory defects.

Key words: Respiratory function tests, Spirometry, Reference values, Global Lung Function Initiative, Aged

中图分类号:

R562

刘春红,田鑫雨,王得翔,石慧,肖伟. 全球肺功能倡议预计值对济南市老年人的适用性检验[J]. 山东大学学报 (医学版), 2018, 56(7): 46-50.

LIU Chunhong, TIAN Xinyu, WANG Dexiang, SHI Hui, XIAO Wei. Applicability of Global Lung Function Initiative 2012 reference equations for spirometry to elderly Chinese in Jinan City[J]. Journal of Shandong University (Health Sciences), 2018, 56(7): 46-50.

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