摘要目的 调查北京地区5~14岁健康儿童肺通气功能主要参数实测值占预计值百分比情况,为临床准确判读提供依据.方法 选择北京地区幼儿园和中小学5~14岁健康儿童400例(男198例,女202例),采用德国Jaeger肺功能仪进行流量容积-曲线测定.收集7项主要肺通气功能参数:呼气峰流量(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC、用力呼出50%肺活量时的流量(FEF50)、用力呼出75%肺活量时的流量(FEF75)、最大呼气中期流量(MMEF).以Jaeger肺功能仪中提供的Zapletal预计值公式(4~18岁)作为所调查儿童的预计值,计算其实测值占预计值的百分比.结果 5~12岁年龄组儿童男女身高、体质量相近,差异均无统计学意义(均P>0.05);13~<14岁、14岁年龄组男童身高、体质量高于女童,差异均有统计学意义(t=3.35、2.05、5.99、2.67,均P<0.05).不同年龄及性别儿童主要肺通气功能参数PEF、FVC、FEV1、FEV1/FVC实测值占预计值百分比均值分别波动于105.0%~114.7%、95.4%~106.8%、104.6%~115.4%、105.8%~112.6%.小气道功能参数FEF50、FEF75、MMEF实测值占预计值百分比分别波动于 79.7%~103.7%、70.2%~110.5%、81.6%~114.7%.不同参数实测值占预计值百分比下限分别为PEF 85.0%,FVC 84.7%,FEV1 92.4%,FEV1/FVC 98.4%,FEF50 67.7%,FEF75 60.1%,MMEF 71.0%.结论 北京地区 5~14岁健康儿童肺通气功能一些参数水平高于Zapletal提供的正常值,可将FEV1 92.4%,FEV1/FVC 98.4%,PEF 85.0%、FVC 84.7%,FEF50 67.7%,FEF75 60.1%,MMEF 71.0%作为实测值占预计值百分比的正常下限.

abstractsObjective To investigate the distribution of measured value and the expected value of spirometry parameters in healthy children aged 5-14 years old in Beijing,and to provide evidence for clinical interpretation precisely.Methods Four hundred healthy children (198 boys and 202 girls) aged 5 to 14 years from the kindergartens and the primary schools in Beijing were selected as subjects.All of the parameters were measured by using Jaeger Masterscreen spirometry machine(Germany).Pulmonary function parameters including forced vital capacity(FVC),forced expiatory volume in 1 second (FEV1),FEV1/FVC,peak expiratory flow(PEF),forced expiratory flow at 50% of vital capacity(FEF50),forced expiratory flow at 75% of vital capacity(FEF75),and the maximal midexpiratory flow(MMEF) were collected for analysis.The expected values of the 7 parameters above were calculated according to Zapletal prediction equations(4-18 years old).The measured value vs.the expected value was calculated.Results Children aged 5 to 12 years had similar height and weight between boys and girls,and the differences were not significant(all P>0.05);while boys were taller and heavier than girls in 13-<14 years old group and 14 years old group,and the diffe-rences were significant(t=3.35,2.05,5.99,2.67;all P<0.05).The mean measured value vs.the expected value of PEF,FVC,FEV1,FEV1/FVC of children in different gender and age groups ranged between 105.0%-114.7%,95.4%-106.8%,104.6%-115.4% and 105.8%-112.6%,respectively.The mean measured value vs.the expected value of small airway function parameters FEF50,FEF75,MMEF was as follows respectively:79.7%-103.7%,70.2%-110.5%,and 81.6%-114.7%.The low limit of normal(LLN) measured value vs.the expected value of the 7 pulmonary function parameters was as follows:PEF 85.0%,FVC 84.7%,FEV1 92.4%,FEV1/FVC 98.4%,FEF50 67.7%,FEF75 60.1%,and MMEF 71.0%.Conclusions The pulmonary function parameters of the healthy children in Beijing are higher than those of the Zapletal prediction.The measured value vs.the expected value of FEV1 92.4%,FEV1/FVC 98.4%,PEF 85.0%,FVC 84.7%,FEF50 67.7%,FEF75 60.1%,and MMEF 71.0% can be used as LLN in 5-14 years old children.