贵州医科大学学报

2019, v.44;No.224(05) 587-590+605

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肺活量和用力肺活量的差值与残气量对慢性阻塞性肺疾病的诊断价值
Correlation Analysis of Difference between Vital Capacity and Forced Vital Capacity and Residual Volume in Chronic Obstructive Pulmonary Disease

韩雪峰;乜庆荣;赵珊;方晓玉;张辉;
HAN Xuefeng;NIE Qingrong;ZHAO Shan;FANG Xiaoyu;ZHANG Hui;Department of Respiration, Liangxiang Hospital in Fangshan District;Department of Respiration, Beijing Chaoyang Hospital;

摘要(Abstract):

目的:探讨慢性阻塞性肺疾病(COPD)患者肺活量(VC)与用力肺活量(FVC)差值(VC-FVC)及残气量(RV)的相关性。方法:204例COPD)患者作为慢阻肺组、212例健康体检者作为对照组,比较两组受检者就诊或体检时VC、FVC、RV、肺总量(TLC)、RV占肺总量的百分比(RV/TLC)及VC-FVC;采用Spearman法对VC-FVC与RV、TLC、RV/TLC的相关性进行分析,绘制VC-FVC、RV、TLC诊断COPD的受试者工作特征曲线(ROC曲线),采用ROC曲线下面积(AUC)评估诊断价值。结果:与对照组比较,慢阻肺组患者VC、FVC显著降低, RV、TLC、RV/TLC及VC-FVC显著升高(P<0.001);Spearman相关分析结果显示,慢阻肺组患者VC-FVC与RV、TLC呈显著正相关(r=0.261、0.262,P<0.001、0.006),VC-FVC与RV/TLC无相关性(r=0.106,P=0.066);对照组VC-FVC与RV、TLC及RV/TLC无相关性(r=0.065、0.026、0.041,P=0.345、0.709、0.552);ROC曲线结果显示,RV、VC-FVC及TCL诊断COPD的AUC面积分别是0.865(95%CI为0.769~0.934)、0.843(95%CI为0.752~0.915)及0.644(95%CI为0.584~0.723),RV、VC-FVC显著高于TCL(P<0.05)。结论:VC和FVC差值与RV均有较好的相关性,可用于评价COPD患者气道陷闭及肺过度充气程度。
Objective: To investigate the correlation of the difference between vital capacity(VC) and forced vital capacity(FVC) with residual volume(RV) of the patients with chronic obstructive pulmonary disease(COPD), and its diagnostic value for COPD. Methods: 204 patients with COPD treated in our hospital from January to August 2018 and 212 healthy controls were selected as subjects in the analysis of the differences and clinical significance of related pulmonary function indicators. Results: There were significant differences in VC, FVC, RV, TLC, RV/TLC and VC-FVC between COPD group and the control group(P<0.001). In COPD group, VC-FVC was positively correlated with RV and TLC(r=0.261,0.262;P<0.001,0.006). There was no correlation between VC-FVC and RV, TLC and RV/TLC in the control group(P>0.05). ROC curve analysis showed that the AUC area of RV and VC-FVC in the diagnosis of COPD was 0.865(95% CI was 0.769~0.934) and 0.843(95% CI: 0.752~0.915) respectively, which was significantly higher than that of TCL(0.644,95% CI was 0.584~0.723,P<0.05), and there was no significant difference between them(P>0.05). Conclusion: The difference between VC and FVC is well correlated with RV, and has excellent diagnostic value for COPD. Therefore, it can help to evaluate the degree of airway trapping and pulmonary hyperinflation in patients with COPD.

关键词(KeyWords): 肺疾病,慢性阻塞性;肺活量;用力呼气量;残气量;ROC曲线;诊断
pulmonary disease,chronic obstructive;vital capacity;forced expiratory volume;residual volume;ROC curve;diagnosis

Abstract:

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基金项目(Foundation): 首都十大危险疾病科研成果推广项目(Z11110006140000)

作者(Author): 韩雪峰;乜庆荣;赵珊;方晓玉;张辉;
HAN Xuefeng;NIE Qingrong;ZHAO Shan;FANG Xiaoyu;ZHANG Hui;Department of Respiration, Liangxiang Hospital in Fangshan District;Department of Respiration, Beijing Chaoyang Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2019.05.018

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