中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2013年
11期
821-824
,共4页
周德训%魏敬安%陈清%改军%陈燕文%高占成
週德訓%魏敬安%陳清%改軍%陳燕文%高佔成
주덕훈%위경안%진청%개군%진연문%고점성
呼吸功能试验%小气道阻塞综合征%肺功能非特异性表现
呼吸功能試驗%小氣道阻塞綜閤徵%肺功能非特異性錶現
호흡공능시험%소기도조새종합정%폐공능비특이성표현
Respiratory function tests%Small airway obstructive syndrome%Non specific pattern
目的 分析肺功能非特异性表现(NSP)患者的肺功能及临床影像诊断的特点,探讨其临床意义.方法 纳入北京大学人民医院呼吸科肺功能室2009年7月1日至2010年2月24日成年患者1933例的肺功能结果,选取其中NSP患者的肺功能数据、临床诊断及影像资料,与肺功能正常人群进行比较分析.正态分布数据组间比较采用t检验,非正态分布数据组问比较采用Mann-Whitney U检验,率的比较采用x2检验.结果 NSP组61例,对照组1017例,体重指数分别为(24.5±4.6)和(24.5±3.8) kg/m2,差异无统计学意义(=0.008,P >0.05);年龄的中位数(四分位间距)分别为64(49 ~74)和56(42 ~70)岁,吸烟指数的中位数(四分位间距)分别为0.4(0 ~20)和0(0~10)包年,差异均有统计学意义(Z值分别为-2.209和-2.571,均P<0.05).NSP组FEV1占预计值%、FVC占预计值%、FEV1/FVC、残气容积占预计值%和肺总量占预计值%的中位数(四分位间距)分别为69% (66% ~73%)、75%(70%~77%)、75% (73% ~78%)、118%(105% ~ 145%)和86% (82% ~ 93%),均显著低于对照组[95%(87%~104%)、98% (90% ~ 106%)、79%(76%~84%)、101%(88% ~114%)和94% (88% ~ 102%)],差异均有统计学意义(Z值为-13.059~-5.185,均P<0.05).NSP组和对照组的残气容积/肺总量分别为(52±11)%和(39±9)%,差异有统计学意义(t=-10.351,P<0.05).肺总量显著降低提示有通气受限,而残气容积和残气容积/肺总量显著升高则提示有气体潴留.NSP组患者的临床诊断包括阻塞性和限制性疾病,部分患者的影像学显示肺部病变严重,有31例无肺部疾病诊断.结论 年龄和吸炯可能对NSP产生影响,肥胖对NSP的影响有限.NSP具有阻塞性和限制性通气功能障碍的特点,但其临床病变范围广泛,无疾病特异性,临床意义有限.
目的 分析肺功能非特異性錶現(NSP)患者的肺功能及臨床影像診斷的特點,探討其臨床意義.方法 納入北京大學人民醫院呼吸科肺功能室2009年7月1日至2010年2月24日成年患者1933例的肺功能結果,選取其中NSP患者的肺功能數據、臨床診斷及影像資料,與肺功能正常人群進行比較分析.正態分佈數據組間比較採用t檢驗,非正態分佈數據組問比較採用Mann-Whitney U檢驗,率的比較採用x2檢驗.結果 NSP組61例,對照組1017例,體重指數分彆為(24.5±4.6)和(24.5±3.8) kg/m2,差異無統計學意義(=0.008,P >0.05);年齡的中位數(四分位間距)分彆為64(49 ~74)和56(42 ~70)歲,吸煙指數的中位數(四分位間距)分彆為0.4(0 ~20)和0(0~10)包年,差異均有統計學意義(Z值分彆為-2.209和-2.571,均P<0.05).NSP組FEV1佔預計值%、FVC佔預計值%、FEV1/FVC、殘氣容積佔預計值%和肺總量佔預計值%的中位數(四分位間距)分彆為69% (66% ~73%)、75%(70%~77%)、75% (73% ~78%)、118%(105% ~ 145%)和86% (82% ~ 93%),均顯著低于對照組[95%(87%~104%)、98% (90% ~ 106%)、79%(76%~84%)、101%(88% ~114%)和94% (88% ~ 102%)],差異均有統計學意義(Z值為-13.059~-5.185,均P<0.05).NSP組和對照組的殘氣容積/肺總量分彆為(52±11)%和(39±9)%,差異有統計學意義(t=-10.351,P<0.05).肺總量顯著降低提示有通氣受限,而殘氣容積和殘氣容積/肺總量顯著升高則提示有氣體潴留.NSP組患者的臨床診斷包括阻塞性和限製性疾病,部分患者的影像學顯示肺部病變嚴重,有31例無肺部疾病診斷.結論 年齡和吸炯可能對NSP產生影響,肥胖對NSP的影響有限.NSP具有阻塞性和限製性通氣功能障礙的特點,但其臨床病變範圍廣汎,無疾病特異性,臨床意義有限.
목적 분석폐공능비특이성표현(NSP)환자적폐공능급림상영상진단적특점,탐토기림상의의.방법 납입북경대학인민의원호흡과폐공능실2009년7월1일지2010년2월24일성년환자1933례적폐공능결과,선취기중NSP환자적폐공능수거、림상진단급영상자료,여폐공능정상인군진행비교분석.정태분포수거조간비교채용t검험,비정태분포수거조문비교채용Mann-Whitney U검험,솔적비교채용x2검험.결과 NSP조61례,대조조1017례,체중지수분별위(24.5±4.6)화(24.5±3.8) kg/m2,차이무통계학의의(=0.008,P >0.05);년령적중위수(사분위간거)분별위64(49 ~74)화56(42 ~70)세,흡연지수적중위수(사분위간거)분별위0.4(0 ~20)화0(0~10)포년,차이균유통계학의의(Z치분별위-2.209화-2.571,균P<0.05).NSP조FEV1점예계치%、FVC점예계치%、FEV1/FVC、잔기용적점예계치%화폐총량점예계치%적중위수(사분위간거)분별위69% (66% ~73%)、75%(70%~77%)、75% (73% ~78%)、118%(105% ~ 145%)화86% (82% ~ 93%),균현저저우대조조[95%(87%~104%)、98% (90% ~ 106%)、79%(76%~84%)、101%(88% ~114%)화94% (88% ~ 102%)],차이균유통계학의의(Z치위-13.059~-5.185,균P<0.05).NSP조화대조조적잔기용적/폐총량분별위(52±11)%화(39±9)%,차이유통계학의의(t=-10.351,P<0.05).폐총량현저강저제시유통기수한,이잔기용적화잔기용적/폐총량현저승고칙제시유기체저류.NSP조환자적림상진단포괄조새성화한제성질병,부분환자적영상학현시폐부병변엄중,유31례무폐부질병진단.결론 년령화흡형가능대NSP산생영향,비반대NSP적영향유한.NSP구유조새성화한제성통기공능장애적특점,단기림상병변범위엄범,무질병특이성,림상의의유한.
Objective To analyze the characteristics of pulmonary function and the clinical significance of non-specific pattern (NSP).Methods A total of 1933 pulmonary function tests of adult patients were analyzed,and those with NSP were selected.The pulmonary function test results,clinical diagnosis and radiological manifestations were analyzed.Normal distribution data were compared by t test,while non-normal distribution data were compared by Mann-Whitney U test,and x2 test was used to compare ratios.Results There were 61 patients in the NSP group and 1017 in the control group.The BMI of the 2 groups was (24.5 ± 4.6) and (24.5 ± 3.8) kg/m2,respectively,being not significantly different (t =0.008,P >0.05).The age was 64 (49-74) years and 56 (42-70) years,and the smoking index was 0.4(0-20) and 0 (0-10),respectively,showing no significant differences (Z values were-2.209 and -2.571,respectively,all P < 0.05).In the NSP group,FEV1 was 69% (66%-73%) predicted,FVC 75% (70%-77%) predicted,FEV1/FVC75% (73%-78%),RV 118% (105%-145%) predicted,and TLC 86% (82%-93%) predicted,which were significantly different as compared to those of the control group [95% (87%-104%),98% (90%-106%),79% (76%-84%),101% (88%-114%)and 94% (88%-102%),respectively],(Z values are-13.059--5.185,all P < 0.05).RV/TLC was (52 ± 11) % in the NSP group and (39 ± 9) % in the control group,the difference being significant (t =-10.351,P < 0.05).The decreased TLC indicated restricted ventilation,while the increased RV and RV/TLC indicated air trapping.The clinical diagnosis of NSP included obstructive and restrictive diseases,some of which showed severe radiological abnormalities,but there were 31 patients without pulmonary lesions.Conclusions Age and smoking,but not obesity,may play a role in NSP.NSP has characteristics of obstructive and restrictive ventilation defects,but does not associate with particular diseases,thus having limited clinical significance.