摘要
目的初探保留比值受损肺功能(PRISm)人群发生慢性阻塞性肺疾病(COPD)的风险。方法将2024年7月~2025年1月上海静安区中心医院连续招募的289例受试者作为研究对象,根据肺功能将其分为PRISm组(n=93)、健康对照组(n=116)和慢性阻塞性肺疾病组(n=80)。比较3组受试者的临床特征、肺通气功能、双向胸部计算机体层扫描(CT)、脉冲震荡肺功能。使用共线性诊断分析、多因素logistic回归模型分析受试者的临床特征、肺通气功能、双向胸部CT结果、脉冲震荡肺功能与COPD的关系。结果3组受试者的临床特征中年龄、体质量指数(BMI)、COPD问卷评分、慢性阻塞性肺疾病评估测试(CAT)评分、吸烟比例、吸烟指数、呼吸系统疾病家族史比例、二手烟暴露比例、生物燃料暴露史比例比较,差异均有统计学意义(F=313.458、240.856、1334.698、3213.604、489.823,χ^(2)=37.346、9.354、35.139、23.841,P<0.05);3组受试者的肺通气功能中第1秒用力呼气容积(FEV1)占预计值百分比、用力肺活量(FVC)占预计值百分比、FEV1/FVC、最大呼气中期流速(MMEF)占预计值百分比、用力呼出50%肺活量的呼气流量(FEF50%)占预计值百分比、用力呼出75%肺活量的呼气流量(FEF75%)占预计值百分比、气道总阻力(R5)占预计值百分比、中心气道阻力(R20)占预计值百分比比较,差异均有统计学意义(F=694.699、470.786、510.356、935.992、1533.161、1375.779、846.651,P<0.05)。经共线性诊断分析、多因素logistics回归分析模型分析,年龄、吸烟、吸烟指数、呼吸系统疾病家族史、二手烟暴露史、生物燃料暴露史均是PRISm人群发生慢性阻塞性肺疾病的影响因素(P<0.05);BMI不是PRISm人群发生慢性阻塞性肺疾病的影响因素(P>0.05)。结论PRISm患者肺通气功能、双向胸部CT、脉冲震荡肺功能中许多指标已发生显著变化,临床需重视PRISm人群的肺功能变化情况,并针对其临床特征积极采取应对措施。
Objective To preliminarily explore the risk of chronic obstructive pulmonary disease(COPD)in population with preserved ratio impaired spirometry(PRISm).Methods From July 2024 to January 2025,289 consecutive subjects were recruited from Shanghai Jing'an District Central Hospital as study participants.According to lung function,the above 289 subjects were divided into PRISm group(n=93),healthy control group(n=116)and COPD group(n=80).The general data,lung ventilation function,bidirectional chest computed tomography(CT)and impulse oscillometry lung function were compared among the three groups.Correlation analysis between demographic characteristics,pulmonary ventilation function,bidirectional chest CT,impulse oscillometry pulmonary function and the occurrence of chronic obstructive pulmonary disease was conducted using collinearity diagnosis analysis and multivariate Logistic regression analysis model.Results There were significant differences among the three groups in terms of age,body mass index(BMI),chronic obstructive pulmonary disease screening questionnaire(COPD questionnaire),chronic obstructive pulmonary disease assessment test(CAT),proportion of smoking,smoking index,proportion of family history of respiratory diseases,proportion of second-hand smoke exposure,proportion of biofuel exposure history,among the three groups were statistically significant(F=313.458、240.856、1334.698、3213.604、489.823,χ^(2)=37.346、9.354、35.139、23.841,P<0.05).percentage of forced expiratory volume in the first second(FEV1)to the predicted value,percentage of forced vital capacity(FVC)to the predicted value,FEV1∕FVC,percentage of maximum mid-expiratory flow rate(MMEF)to the predicted value,percentage of forced expiratory flow of 50%vital capacity(FEF50%)to the predicted value,percentage of forced expiratory flow of 75%vital capacity(FEF75%)to the predicted value,percentage of total airway resistance(R5)to the predicted value,percentage of central airway resistance(R20)to the predicted value and MLDE∕I(F=694.699、470.786、510.356、935.992、1533.161、1375.779、846.651,P<0.05).Through the analysis of collinearity and the multi-factor Logistic regression model analysis,age,smoking,smoking index,family history of respiratory diseases,exposure to second-hand smoke,and exposure to biofuels were positively correlated with the occurrence of chronic obstructive pulmonary disease(P<0.05);while BMI was not significantly correlated with the occurrence of chronic obstructive pulmonary disease(P>0.05).Conclusion Many indicators of pulmonary ventilation function,bidirectional chest CT,and pulse oscillation lung function in PRISm patients have significantly changed.Therefore,in clinical practice,it is necessary to pay attention to the changes in lung function of the PRISm population and take active measures based on their clinical characteristics.
作者
朱利芹
肖琳
冯莹
闫景霞
姜嘟嘟
曹惠芳
ZHU Liqin;XIAO Lin;FENG Ying;YAN Jingxia;JIANG Dudu;CAO Huifang(Department of Respiratory,Shanghai Jing'an District Central Hospital,Shanghai 200040,China;Jiang ning Road,Jing'an District,Shanghai Community Health Services Center Shanghai 200040,China)
出处
《中华保健医学杂志》
2025年第6期953-957,共5页
Chinese Journal of Health Care and Medicine
基金
上海市静安区卫生科研课题(2024MS05)。
关键词
保留比值受损肺功能
肺通气功能
症状评分
慢性阻塞性肺疾病
preserved ratio impaired spirometry
lung ventilation function
symptom score
chronic obstructive pulmonary disease
