无症状健康体检者肺通气功能异常检出率及其小气道功能障碍相关危险因素分析
Prevalence of abnormal lung function and risk factors of small airway dysfunction in asymptomatic healthy subjects receiving physical examination
摘要目的:分析无症状健康体检者肺通气功能异常检出率及其小气道功能障碍(SAD)相关危险因素。方法:分析2016年8月—2017年10月,首都医科大学附属复兴医院610例符合本研究标准的健康体检者肺功能检查结果,描述肺功能异常检出率;比较健康体检中吸烟者与非吸烟者、不同烟龄者、体重正常与肥胖者之间肺通气功能指标的差异;分析SAD的危险因素;总结无症状健康体检者肺功能变化特点。结果:610例接受肺功能检查的体检者中,肺通气功能异常总检出率为42.6%,其中阻塞性、限制性、混合性通气功能障碍及单纯SAD检出率分别为:16.7%、5.9%、2.5%及17.5%;第1秒用力呼气容积(FEV 1)与用力肺活量(FVC)的比值(FEV 1/FVC)<70%者检出率为4.6%;吸烟者小气道功能指标:最大呼气中期流量(MMEF)、用力呼出50%及75%肺活量时的瞬间呼气流量(FEF 50%、FEF 75%)均明显低于非吸烟者,随着烟龄的增加进行性下降;吸烟是SAD的独立风险因子,与不吸烟者相比,吸烟者患SAD的风险增加了65倍;肥胖与SAD无关。 结论:无症状健康体检者肺功能异常率高,主要异常表现为阻塞性通气功能障碍及SAD,吸烟是SAD的主要危险因素。
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abstractsObjective:To investigate the prevalence of abnormal lung ventilation function in asymptomatic subjects receiving healthy examination and the risk factors of small airway dysfunction (SAD).Methods:From August 2016 to October 2017, the pulmonary function test results of 610 healthy subjects who met the standards of this study in Fuxing Hospital affiliated to Capital Medical University were analyzed. The detection rate of abnormal lung function was described; the difference of lung function was compared between smokers and non-smokers, among groups with different smoking age, between individuals with normal body mass index and obese individuals; the risk factors of SAD was investigated; and the characteristics of abnormal lung function in asymptomatic subjects receiving physical examinations were summarized.Results:Among the 610 subjects, the overall prevalence of abnormal pulmonary function was 42.6%, and the rate of obstructive, restrictive, mixed and pure SAD were 16.7% and 5.9%, 2.5% and 17.5% respectively. The prevalence of the ratio of forced expiratory volume in 1 second (FEV 1) to forced vital capacity (FVC) (FEV 1/FVC) less than 70% was 4.6%; small airway function indicators of maximal mid expiratory flow (MMEF), forced expiratory flow at 50% and 75% of forced vital capacity (FEF 50% and FEF 75%) for smokers were significantly lower than that of non-smokers, and decreased progressively with smoking age. Smoking was an independent risk factor for SAD. Compared with non-smokers, smokers had a 65-fold increase in the risk of SAD. Obesity was not associated with SAD. Conclusions:The prevalence of abnormal lung function is high in asymptomatic subjects receiving healthy examination. The main abnormalities are obstructive ventilation dysfunction and SAD. Cigarette smoking is the major risk factor for SAD.
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