背景:虽然已有充分证据表明成人的肺弥散能力随年龄增加而减少,但年龄范围中体质量、性别及身高等相关因素对呼吸膜弥散能力及肺毛细血管血流量的影响,以及此项因素下呼吸膜弥散能力与肺毛细血管血流量及肺弥散能力关系尚需深入探讨.目的:探讨正常人的呼吸膜弥散能力(Dm)和肺毛细血管血流量与肺弥散能力及年龄、身高、体质量和性别的关系.设计:以健康成人为观察对象,采用多元线性相关、逐步回归方法计算相关系数及回归方程,组间差异使用F检验及Q检验.对象:选择1997-04/1997-10解放军总医院门诊查体健康受试者100人,男女各50例,分成5个年龄组,分别为20～29,30～39,40～49,50～59,60～69岁组,每组20人,男女各10人.均自愿参加.方法:健康成人肺弥散能力和呼吸膜弥散能力测定使用Sensormedics 2200肺功能仪,肺毛细血管血流量测定后采用公式法计算(1/肺弥散能力=1/呼吸膜弥散能力+1/θ肺毛细血管血流量,θ是一氧化碳与血红蛋白结合速率,与吸入气体的氧分压成反比,呼吸膜弥散能力、肺毛细血管血流量不受θ的影响).采用多元线性相关、逐步回归方法计算肺弥散能力,呼吸膜弥散能力、肺毛细血管血流量相关性,采用回归方程显示年龄、身高、体质量与肺功能的关系.主要观察指标:正常人的呼吸膜弥散能力和肺毛细血管血流量与肺弥散能力、年龄、身高和体质量的关系.结果:按意向处理分析,健康成人100人均进入结果分析.①健康成人100人肺弥散能力、呼吸膜弥散能力在40岁以后随年龄增加而呈下降趋势(P＜0.05),肺毛细血管血流量在50岁以后随年龄增加呈下降趋势(P＜0.05).②女性年龄及各项肺功能间的关系:年龄与肺弥散能力、呼吸膜弥散能力、肺毛细血管血流量呈显著负相关(r=-0.646 0～-0.814 6,P＜0.01).肺弥散能力与呼吸膜弥散能力、肺毛细血管血流量、肺泡通气量呈显著正相关(r=0.949 7,0.740 0,0.735 6,P＜0.01).肺泡通气量与肺弥散能力、呼吸膜弥散能力、肺毛细血管血流量呈中度或高度正相关(r=0.482 1～0.740 6,P＜0.01).③男性年龄及各项肺功能间的关系:年龄与肺弥散能力、呼吸膜弥散能力、肺毛细血管血流量呈显著负相关(r=-0.712～-0.830 5,P＜ 0.01).肺弥散能力与呼吸膜弥散能力、肺毛细血管血流量、肺泡通气量呈中度或高度正相关(r=0.585 2～946 0,P＜0.01).肺泡通气量与肺弥散能力、呼吸膜弥散能力、肺毛细血管血流量呈中度正相关(r=0.431 3～0.585 2,P＜0.01).④经逐步回归统计,身高与年龄为进入肺弥散能力、呼吸膜弥散能力、肺毛细血管血流量预计公式的主要变量,在女性组,体质量未能进入回归方程,男性组仅在肺弥散能力、肺毛细血管血流量中进入,回归系数分别为0.009 4,0.654 3.结论:①健康成人呼吸膜弥散能力和呼吸膜弥散能力在40岁以后开始降低,肺毛细血管血流量的减少发生在50岁以后.②健康成人肺弥散能力、呼吸膜弥散能力、肺毛细血管血流量随年龄的增加而减弱或下降.③肺弥散能力随呼吸膜弥散能力和肺毛细胞血管血流量增强和增大而增强.④身高和/或年龄是呼吸膜弥散能力、肺毛细血管血流量回归方程的主要变量,在呼吸膜弥散能力、肺毛细血管血流量的预计公式中,体质量并非主要预计因素.
揹景:雖然已有充分證據錶明成人的肺瀰散能力隨年齡增加而減少,但年齡範圍中體質量、性彆及身高等相關因素對呼吸膜瀰散能力及肺毛細血管血流量的影響,以及此項因素下呼吸膜瀰散能力與肺毛細血管血流量及肺瀰散能力關繫尚需深入探討.目的:探討正常人的呼吸膜瀰散能力(Dm)和肺毛細血管血流量與肺瀰散能力及年齡、身高、體質量和性彆的關繫.設計:以健康成人為觀察對象,採用多元線性相關、逐步迴歸方法計算相關繫數及迴歸方程,組間差異使用F檢驗及Q檢驗.對象:選擇1997-04/1997-10解放軍總醫院門診查體健康受試者100人,男女各50例,分成5箇年齡組,分彆為20～29,30～39,40～49,50～59,60～69歲組,每組20人,男女各10人.均自願參加.方法:健康成人肺瀰散能力和呼吸膜瀰散能力測定使用Sensormedics 2200肺功能儀,肺毛細血管血流量測定後採用公式法計算(1/肺瀰散能力=1/呼吸膜瀰散能力+1/θ肺毛細血管血流量,θ是一氧化碳與血紅蛋白結閤速率,與吸入氣體的氧分壓成反比,呼吸膜瀰散能力、肺毛細血管血流量不受θ的影響).採用多元線性相關、逐步迴歸方法計算肺瀰散能力,呼吸膜瀰散能力、肺毛細血管血流量相關性,採用迴歸方程顯示年齡、身高、體質量與肺功能的關繫.主要觀察指標:正常人的呼吸膜瀰散能力和肺毛細血管血流量與肺瀰散能力、年齡、身高和體質量的關繫.結果:按意嚮處理分析,健康成人100人均進入結果分析.①健康成人100人肺瀰散能力、呼吸膜瀰散能力在40歲以後隨年齡增加而呈下降趨勢(P＜0.05),肺毛細血管血流量在50歲以後隨年齡增加呈下降趨勢(P＜0.05).②女性年齡及各項肺功能間的關繫:年齡與肺瀰散能力、呼吸膜瀰散能力、肺毛細血管血流量呈顯著負相關(r=-0.646 0～-0.814 6,P＜0.01).肺瀰散能力與呼吸膜瀰散能力、肺毛細血管血流量、肺泡通氣量呈顯著正相關(r=0.949 7,0.740 0,0.735 6,P＜0.01).肺泡通氣量與肺瀰散能力、呼吸膜瀰散能力、肺毛細血管血流量呈中度或高度正相關(r=0.482 1～0.740 6,P＜0.01).③男性年齡及各項肺功能間的關繫:年齡與肺瀰散能力、呼吸膜瀰散能力、肺毛細血管血流量呈顯著負相關(r=-0.712～-0.830 5,P＜ 0.01).肺瀰散能力與呼吸膜瀰散能力、肺毛細血管血流量、肺泡通氣量呈中度或高度正相關(r=0.585 2～946 0,P＜0.01).肺泡通氣量與肺瀰散能力、呼吸膜瀰散能力、肺毛細血管血流量呈中度正相關(r=0.431 3～0.585 2,P＜0.01).④經逐步迴歸統計,身高與年齡為進入肺瀰散能力、呼吸膜瀰散能力、肺毛細血管血流量預計公式的主要變量,在女性組,體質量未能進入迴歸方程,男性組僅在肺瀰散能力、肺毛細血管血流量中進入,迴歸繫數分彆為0.009 4,0.654 3.結論:①健康成人呼吸膜瀰散能力和呼吸膜瀰散能力在40歲以後開始降低,肺毛細血管血流量的減少髮生在50歲以後.②健康成人肺瀰散能力、呼吸膜瀰散能力、肺毛細血管血流量隨年齡的增加而減弱或下降.③肺瀰散能力隨呼吸膜瀰散能力和肺毛細胞血管血流量增彊和增大而增彊.④身高和/或年齡是呼吸膜瀰散能力、肺毛細血管血流量迴歸方程的主要變量,在呼吸膜瀰散能力、肺毛細血管血流量的預計公式中,體質量併非主要預計因素.
배경:수연이유충분증거표명성인적폐미산능력수년령증가이감소,단년령범위중체질량、성별급신고등상관인소대호흡막미산능력급폐모세혈관혈류량적영향,이급차항인소하호흡막미산능력여폐모세혈관혈류량급폐미산능력관계상수심입탐토.목적:탐토정상인적호흡막미산능력(Dm)화폐모세혈관혈류량여폐미산능력급년령、신고、체질량화성별적관계.설계:이건강성인위관찰대상,채용다원선성상관、축보회귀방법계산상관계수급회귀방정,조간차이사용F검험급Q검험.대상:선택1997-04/1997-10해방군총의원문진사체건강수시자100인,남녀각50례,분성5개년령조,분별위20～29,30～39,40～49,50～59,60～69세조,매조20인,남녀각10인.균자원삼가.방법:건강성인폐미산능력화호흡막미산능력측정사용Sensormedics 2200폐공능의,폐모세혈관혈류량측정후채용공식법계산(1/폐미산능력=1/호흡막미산능력+1/θ폐모세혈관혈류량,θ시일양화탄여혈홍단백결합속솔,여흡입기체적양분압성반비,호흡막미산능력、폐모세혈관혈류량불수θ적영향).채용다원선성상관、축보회귀방법계산폐미산능력,호흡막미산능력、폐모세혈관혈류량상관성,채용회귀방정현시년령、신고、체질량여폐공능적관계.주요관찰지표:정상인적호흡막미산능력화폐모세혈관혈류량여폐미산능력、년령、신고화체질량적관계.결과:안의향처리분석,건강성인100인균진입결과분석.①건강성인100인폐미산능력、호흡막미산능력재40세이후수년령증가이정하강추세(P＜0.05),폐모세혈관혈류량재50세이후수년령증가정하강추세(P＜0.05).②녀성년령급각항폐공능간적관계:년령여폐미산능력、호흡막미산능력、폐모세혈관혈류량정현저부상관(r=-0.646 0～-0.814 6,P＜0.01).폐미산능력여호흡막미산능력、폐모세혈관혈류량、폐포통기량정현저정상관(r=0.949 7,0.740 0,0.735 6,P＜0.01).폐포통기량여폐미산능력、호흡막미산능력、폐모세혈관혈류량정중도혹고도정상관(r=0.482 1～0.740 6,P＜0.01).③남성년령급각항폐공능간적관계:년령여폐미산능력、호흡막미산능력、폐모세혈관혈류량정현저부상관(r=-0.712～-0.830 5,P＜ 0.01).폐미산능력여호흡막미산능력、폐모세혈관혈류량、폐포통기량정중도혹고도정상관(r=0.585 2～946 0,P＜0.01).폐포통기량여폐미산능력、호흡막미산능력、폐모세혈관혈류량정중도정상관(r=0.431 3～0.585 2,P＜0.01).④경축보회귀통계,신고여년령위진입폐미산능력、호흡막미산능력、폐모세혈관혈류량예계공식적주요변량,재녀성조,체질량미능진입회귀방정,남성조부재폐미산능력、폐모세혈관혈류량중진입,회귀계수분별위0.009 4,0.654 3.결론:①건강성인호흡막미산능력화호흡막미산능력재40세이후개시강저,폐모세혈관혈류량적감소발생재50세이후.②건강성인폐미산능력、호흡막미산능력、폐모세혈관혈류량수년령적증가이감약혹하강.③폐미산능력수호흡막미산능력화폐모세포혈관혈류량증강화증대이증강.④신고화/혹년령시호흡막미산능력、폐모세혈관혈류량회귀방정적주요변량,재호흡막미산능력、폐모세혈관혈류량적예계공식중,체질량병비주요예계인소.
BACKGROUND: Although pulmonary diffusion capacity (PDC) has been substantially proved in a declining tendency in age-dependent manner, the effects of such related factors as body mass, sex and height within an age range on pulmonary membrane conductance (Dm) and capillary blood volume (CBV), as well as the correlation of Dm with CBV and PDC deserve further investigation.OBJECTIVE: To study the correlation of Dm and CBV with PDC, age,body mass, height and sex in normaladults.DESIGN: With healthy adults as subjects, multiple factor linear correlation and regression analysis was used to elicit correlation coefficient and regression equation while F-test and Q-test were used for comparing the differences between groups.PARTICIPANTS: We randomly selected 100 healthy adults, 50 males and 50 females, who came to the clinic of the General Hospital of Chinese PLA for routine physical examination between April and October 1997.The 100 volunteers were divided into five groups according to their age:20-29, 30-39, 40-49, 50-59 and 60-69 years old groups with 20 in each group, half males and half females.METHODS: PDC and Dm of the healthy adults were examined with Sensormedics 2200 pulmonary function detector. CBV was calculated with the following formula (1/PDC=I/ Dm +1/θCBV, θrefers to the combined velocity of CO with Hb, which was in inverse proportion to the inhaled partial oxygen pressure, Dm and CBV were unaffected by θ). Multiple factor linear correlation and progressive regression analysis was used to elicit correlation coefficient of PDC, Dm and CBV. Meanwhile, regression equation was used to reveal the correlation of age, body mass and height with pulmonary functions.MAIN OUTCOME MEASURES: Correlation ofDm and CBV with PDC and age, body mass, height and sex in normal adults.RESULTS: Data of the 100 healthy adults were processed according to the objective and statistically analyzed. ① PDC and Dm were proved to decline in age-dependent manner from the onset of 40 years old in the 100 healthy adults (P＜ 0.05), and CBV also declined after 50 years old (P ＜ 0.05). ②Relationship between women's age and pulmonary function: Age was proved to have significant negative correlation with PDC,Dm and CBV (r= -0.646 0 to -0.814 6, P＜ 0.01). By contrast, PDC was found to be positively correlated with Dm, CBV and alveolus ventilation volume (AVV) (r=0.949 7, 0.740 0, 0.735 6, P＜ 0.01), and AVV was found to be positively correlated with PDC, Dm and CBV (r=0.482 1-0.740 6,P＜ 0.01). ③ Relationship between men's age and pulmonary function:Age had significant negative correlation with PDC, Dm and CBV (r=-0.712 to -0.830 5, P＜ 0.01). However, PDC was found to be moderately or highly positively correlated with Dm, CBV and AVV (r=0.585 2 to 0.946 0, P＜ 0.01), and AVV had moderately positive correlation with PDC, Dm and CBV (r=0.431 3-0.585 2, P＜ 0.01). ④ Regression analysis revealed that age and height were the main variables of the predicting equation of PDC,Dm and CBV. Body mass could not enter regression equation in females,and it was only proved to be correlated with PDC and CBV in males with the regression coefficient of 0.009 4 and 0.654 3, respectively.CONCLUSION: ① PDC and Dm begin to decline from the onset of 40 years old in healthy adults (P＜ 0.05), and CBV declines after 50 years old.② PDC, Dm and CBV of healthy adults are proved to decline in age-dependent manner. ③ PDC increases with the increment of Dm and CBV. ④ Age and/or height are the main variables in the regression equation of PDC, Dm and CBV, but body mass is not the key predictor for Dm and CBV.
