无症状吸烟者的肺功能改变情况分析

目的：探讨烟龄215年,日吸烟量≥15支的无症状男性吸烟者的肺功能改变情况。方法：选择男性无症状吸烟者190人及非吸烟者180人,进行肺功能测定,并比较两组人群的肺功能改变情况。结果：吸烟组与非吸烟组比较,肺活量（VC）、用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、Tiffeneau1秒率（FEV1／VC）结果改变不明显,而Gaensler1秒率（FEV1/FVC）、最大分钟通气量（MVV）、用力呼气50％肺活量的呼气流量（FEF50％）、用力呼气75％肺活量的呼气流量（FEF75％）、呼出25％-75％肺活量时的平均流量（FEF25％～75％）、肺一氧化碳弥散量（DLCO）结果均有显著降低,有统计学意义。结论：通过对无症状吸烟人群肺功能测定结果进行分析。发现有些吸烟者虽无临床症状,但已经出现了小气道及肺弥散功能的损伤,提醒吸烟者应早期戒烟,关爱自身健康,净化生存环境,提高生活质量。     

儿童青少年肺通气功能预测的后向传播神经网络方法

本文旨在研究儿童青少年肺通气功能预测的后向传播神经网络(backpropagation neural network,BPNN)方法,以期得到更准确的肺通气功能预计值。样本数据包括内蒙古自治区10~18岁汉族健康儿童青少年999人(男性500人,女性499人),测量身高和体重,使用肺功能仪检测肺通气功能。利用BPNN和多元逐步回归,对用力肺活量(forced vital capacity,FVC)、用力呼气一秒量(forced expiratory volume in one second,FEV1)、最大呼气流量(peak expiratory flow,PEF)、用力呼出25%肺活量时呼气流量(forced expiratory flow at25%of forced vital capacity,FEF25%)、用力呼出50%肺活量时呼气流量(forced expiratoryflow at50%of forced vital capacity,FEF50%)、最大呼气中段流量(maximal mid-expiratory flow,MMEF)、用力呼出75%肺活量时呼气流量(forced expira...     

儿童青少年脂肪体重、去脂体重和肺通气功能的关系

本文旨在研究儿童青少年去脂体重(fat free mass,FFM)、脂肪体重(fat mass,FM)和肺通气功能的关系。随机抽取黑龙江省10～18岁健康儿童青少年1174人(男性583人,女性591人),测量身高、体重和腰臀比(waist to hip ratio,WHR),使用身体成分测量仪和肺功能仪分别测量FFM、FM和肺通气功能,采用独立样本t检验、偏相关和多元逐步回归分析FFM、FM和肺通气功能的关系。结果显示,无论性别,受试者年龄与去脂体重指数(FFM index,FFMI)呈正相关(P0.001)。男性年龄和脂肪体重指数(FM index,FMI)呈负相关(P0.001),女性年龄和FMI呈正相关(P0.001)。无论性别,受试者FFMI与用力呼气肺活量(forced vital capacity,FVC)、用力呼气一秒量(forced expiratory volume in one second,FEV1)、最大呼气流量(peak expiratory flow,PEF)、用力呼出25%肺活量时呼气流量(forced expiratory flow at25%of forced vital capacity,FEF25%)、FEF50%和最大呼气中段流量(maximum mid-expiratory flow,MMEF)都呈正相关(P0.05),与FEV1/FVC呈负相关(P0.01)。男性FFMI与FEF75%正相关(P0.05),女性FFMI与FEF75%不相关。男性FMI与FEV1、FEV1/FVC、PEF、FEF25%、FEF50%、FEF75%和MMEF呈负相关(P0.05),而与FVC不相关。女性FMI与肺通气功能的指标均不相关。除男性FEV1/FVC和FEF75%外,无论性别,FFMI对肺通气功能指标的预测作用大于FMI。FFMI对男性肺通气功能预测作用大于女性。男性肺功能突增发生在12～15岁:FVC较前一个年龄段分别增加10.05%、20.41%、11.75%和9.00%,FEV1分别较前一年龄段增加11.38%、20.07%、12.01%和9.14%。女性肺功能突增发生在12、13和18岁:FVC较前一年龄段分别增加13.73%、9.07%和9.76%,FEV1较前一年龄段分别增加13.17%、11.12%和10.62%。在肺功能突增期,无论性别,FFMI对肺功能的预测作用大于年龄的预测作用。综上所述,无论性别,反映骨骼肌力的FFM与肺通气功能呈正相关,对男性肺通气功能的预测作用大于女性。FM与男性肺通气功能呈负相关,而与女性肺通气功能不相关。在肺功能突增期,身高和FFM的快速增长可能是造成肺功能快速增长的主要原因。     

变异性咳嗽病人肺通气功能检测结果分析

目的分析肺通气功能检测在变异性咳嗽患者诊断中的价值。方法选择2013年1~12月在我院呼吸科门诊确诊为变异性咳嗽的患者80例(发作组),行肺通气功能检测,内容包括用力肺活量(FVC),第一秒最大时间肺活量(FEV1)一秒率(FEV1/FVC)测定,呼气流量峰值(PEF%)和最大呼气中段流量(FEV25%,FEV50%,FEV75%)等指标,并与同期健康体检者50例(对照组)对照分析。结果发作组肺通气功能指标低于对照组,小气道指标FEV25%,FEV50%,FEV75%,MMEF较大气道指标FEV1,MEFV,FEV1/FVC下降较明显。结论肺通气功能的检测可以评价变异性咳嗽患者的小气道功能障碍,为其诊断和病情的动态观察提供依据。     

成年人脂肪体重、去脂体重和肺通气功能的关系

本文旨在研究分析成年人去脂体重(fat free mass,FFM)、脂肪体重(fat mass,FM)和肺通气功能的关系。随机抽取黑龙江省部分地区19~81岁健康成年人群1307人(男性372人,女性935人),测量身高、体重,采用身体成分仪和肺功能仪分别检测FFM、FM和肺通气功能,并采用Pearson相关分析、独立样本t检验和多元逐步回归等统计学方法分析FFM、FM和肺通气功能的关系。结果显示,无论性别,年龄均与脂肪体重指数(FM index,FMI)呈正相关(P0.001),去脂体重指数(FFM index,FFMI)和用力肺活量(forced vital capacity,FVC)、用力呼气一秒量(forced expiratory volume in one second,FEV1)、最高呼气流量(peak expiratory flow,PEF)、用力呼出25%肺活量时呼气流量(forced expiratory flow at25%of forcedvital capacity,FEF25%)均呈正相关(P0.01),FMI和FVC、FEV1、FEF75%呈负相关(P0.05)。男性FMI和最大呼气中段流量(maximal mid-expiratory flow,MMEF)呈负相关(P0.05)。无论性别,FFMI对于FVC作用大于FMI,而对于FEV1,男性FMI作用大于FFMI,女性则反之。无论性别,FFMI升高,PEF和FEF25%也升高,而FMI对二者无作用。无论性别,FMI升高,FEF75%降低,而FFMI对其无作用。FMI升高,男性MMEF降低,女性无明显改变。本研究结果表明,FFM和FM均是影响肺通气功能的独立因素,反映骨骼肌力的FFM与肺通气功能呈正相关,FM与肺通气功能呈负相关。FFM和FM对肺通气功能作用大小存在差别。     

肺功能监测和CT肺功能成像检查结果的相关性分析

目的:探讨CT肺功能参数与肺功能检查参数的相关性及CT肺功能成像技术的可行性。方法:选取2011年7月至2015年6月在我院进行肺部检查的患者80例作为研究对象。所有患者均在1周内完成PFT和胸部CT检查。采用最大吸气末和最大呼气末屏气螺旋CT扫描。用CT肺功能定量软件分析CT扫描图像。结果:吸气末肺体积与PFT的最大肺总量明显相关,呼气末CT测得的肺体积与残气量、呼吸比与RV/TLC有相关性,吸气第1秒用力呼吸量(FEV1)/用力肺活量(FVC)存在相关性。像素指数(PI)=-910~-950 HU,与FEV1、FEV1%、FEV1/FVC及FVC%相关,其中与FEV1/FVC的相关性最大。呼气相平均CT值与FEV1、FEV1%、FVC%、FEV1/FVC存在相关性。呼气相CT各阈值与PFT参数均相关。结论:行螺旋CT扫描测得最大吸气末及最大呼气末与PFT结果相关性好,因此CT肺功能定量成像技术可能是一种良好的测定肺功能相关参数的技术。     

慢性阻塞性肺疾病急性加重期患者血清PCT、hs-CRP、D-D和FIB与肺功能和预后的关系研究

目的:探究慢性阻塞性肺疾病急性加重期(AECOPD)患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)和纤维蛋白原(FIB)与肺功能和预后的关系。方法:选择2017年8月至2019年8月期间我院诊治的88例AECOPD患者作为观察组,根据患者生存情况将患者进一步分为85例存活组和3例死亡组。同时选择同期在我院进行健康体检的50名志愿者作为对照组。检测各组患者的血清PCT、hs-CRP、D-D和FIB水平,采用肺功能检测仪检测第一秒用力呼气容积(FEV1)%、第一秒用力呼气容积占用力肺活量比值(FEV1/FVC)和最大通气量(MVV)肺功能指标,采用Pearson相关性分析进行各指标的相关性分析。结果:与对照组相比,观察组的血清PCT、hs-CRP、D-D和FIB水平均明显升高(P0.05)。与存活组相比,死亡组的血清PCT、hs-CRP、D-D和FIB水平均明显升高(P0.05),FEV1%、FEV1/FVC和MVV指标均明显下降(P0.05)。Pearson相关性分析显示,血清PCT、hs-CRP、D-D和FIB水平均与FEV1%、FEV1/FVC和MVV肺功能指标呈负相关(P0.05)。结论:AECOPD患者肺功能下降和不良预后与血清PCT、hs-CRP、D-D和FIB水平升高密切相关,在AECOPD患者的预后预测中具有一定临床价值。     

肺炎支原体抗体阳性对咳嗽变异性哮喘患儿肺功能的影响研究

目的:通过探讨肺炎支原体(MP)抗体阳性感染对咳嗽变异性哮喘(CVA)患儿肺功能的影响,为临床治疗提供依据。方法:选择2012年6月~2014年6月本院收治的CVA患儿共60例,依据支原体抗体检查和肺功能检测结果,分为CVA合并MP组(合并组)和CVA组,检测两组患儿初诊时肺通气功能、支气管激发试验阳性率,分析初诊时、治疗1、3个月后MP抗体对肺功能第一秒用力呼吸容积/用力肺活量(FEV1%)的影响。结果:初诊时两组患儿肺活量(FVC)、最大呼气峰流速(PEF)、FEV1%、最大中段呼气流速(MMEF75/25)实测值均低于预测值(P0.05),合并组MMEF75/25预测值/实测值的比值较CVA组高(P0.05)。支气管激发试验阳性患儿中,合并组以轻度和极轻度为主,CVA组以重度和中度为主(P0.05)。MP抗体滴度持续阳性和阴性患儿FEV1%无统计学差异(P0.05)。结论:合并MP抗体阳性CVA患儿气道高反应性程度较低,小气道阻塞加重,对肺通气功能无影响。     

慢性阻塞性肺疾病急性加重期患者血清SAA水平与肺功能、炎性因子的相关性及其诊断价值分析

目的:探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血清淀粉样蛋白A(SAA)水平与肺功能及炎性因子的相关性,并分析其诊断价值。方法:选取2013年6月-2018年6月中国人民解放军第970医院收治的204例慢性阻塞性肺疾病(COPD)患者作为研究对象,其中COPD稳定期患者132例作为COPD稳定组,AECOPD患者72例作为AECOPD组。另选取同期于中国人民解放军第970医院进行健康体检的50例健康体检者作为健康组。比较三组受试者血清SAA水平、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)水平及肺功能,采用Pearson相关性分析AECOPD患者血清SAA水平与肺功能及炎性因子的相关性,并分析SAA对AECOPD的诊断价值。结果:AECOPD组患者血清SAA、PCT、CRP、IL-6、IL-8水平较COPD稳定组及健康组升高(P0.05),COPD稳定组患者血清SAA、IL-6、IL-8、PCT、CRP水平均高于健康组,差异有统计学意义(P0.05);AECOPD组患者第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、第一秒用力呼吸容积占用力肺活量的百分比(FEV1/FVC%)、第一秒用力呼气容积占预计值百分比(FEV1%)低于COPD稳定组及健康组,差异有统计学意义(P0.05),COPD稳定组患者FEV1、FVC、FEV1/FVC%、FEV1%低于健康组,差异有统计学意义(P0.05)。Pearson相关性分析显示,AECOPD患者血清SAA水平与IL-8、IL-6、CRP、PCT呈正相关,与FEV1%、FEV1/FVC%、FEV1、FVC呈负相关(P0.05)。受试者工作特征(ROC)曲线结果显示,SAA对AECOPD诊断的敏感度为80.85%,特异度为80.07%,曲线下面积为0.832。结论:AECOPD患者血清SAA水平明显升高,其与患者肺功能及炎症因子存在相关性,具有较高的诊断价值,可用于AECOPD患者病情的评估。     

Wistar大鼠肺功能参考值范围测定

目的建立Wistar大鼠肺功能各项指标的参考值。方法用创体描法小动物肺功能检测仪检测大鼠肺功能各项指标,根据肺功能指标检测结果,通过统计分析,确定其参考值范围。结果 Ri（吸气阻力）为1.81（0.94~4.10）cm H2O/（mL·s）,Re（呼气阻力）为1.83（0.71~3.57）cm H2O/（mL·s）,Cl（肺顺应性）为0.15（0.05~0.29）mL/cm H2O,MVV（最大通气量）为144.65（77.28~256.20）mL/min,FVC（用力肺活量）为8.49（5.82~12.70）mL,Fev0.2（第0.2秒用力呼气容积）为5.72（3.62~7.01）mL,Fev0.2/FVC（第0.2秒用力呼出容积占用力肺活量百分比）为8.12（39.14~85.28）%,FEF（25~75）%（用力中期呼气流速）为34.11（28.25~46.87）mL/min。PEF（用力最大呼气流速）为38.28（30.75~50.25）mL/min。结论 Wistar大鼠肺功能指标的参考值范围可为临床和科研工作以及未来制定国家标准和规范提供参考依据。     

Pioglitazone is as effective as dexamethasone in a cockroach allergen-induced murine model of asthma

Background

The aims of this study were to verify the feasibility of respiratory function tests and to assess their validity in the diagnosis of respiratory disorders in young children.

Methods

We performed spirometry and collected information on health and parents' lifestyle on a sample of 960 children aged 3–6.

Results

The cooperation rate was 95.3%. Among the valid tests, 3 or more acceptable curves were present in 93% of cases. The variability was 5% within subjects in 90.8% of cases in all the parameters. We propose regression equations for FVC (Forced Vital Capacity), FEV1, FEV0.5, FEV0.75 (Forced Expiratory Volume in one second, in half a second and in 3/4 of a second), and for Maximum Expiratory Flows at different lung volume levels (MEF75, 50, 25). All parameters are consistent with the main reference values reported in literature. The discriminating ability of respiratory parameters versus symptoms always shows a high specificity (>95%) and a low sensitivity (<20%) with the highest OR (10.55; IC95% 4.42–25.19) for MEF75. The ability of FEV0.75 to predict FEV1 was higher than that of FEV0.50: FEV0.75 predicts FEV1 with a determination coefficient of 0.95.

Conclusion

Our study confirms the feasibility of spirometry in young children; however some of the current standards are not well suited to this age group. Moreover, in this restricted age group the various reference values have similar behaviour.     

Smoking,lung function,and body weight.

In a cross-sectional study of steelworkers aged 45-55 years, smokers (n = 105; mean weight 76.1 kg) were found to weigh significantly less than non-smokers (n = 54; 81.6 kg) and ex-smokers (n = 51; 82.6 kg). The lower weight of smokers was attributable to a group with airflow obstruction (n = 37; forced expiratory volume in one second/vital capacity (FEV1/VC) less than 66%), who weighed less (4.8 kg; p less than 0.05) than smokers with normal FEV1/VC (n = 68). In smokers, but not in ex-smokers or non-smokers, body mass index and FEV1/VC ratio were closely related (r = 0.34; p less than 0.001). This association was apparently not due to an effect of body weight on lung function. Weight loss in smokers may be the consequence of impaired lung function or reflect the effect of cigarette smoking on both the respiratory tract and metabolism in susceptible subjects.     

The association between blood coagulation activity and lung function: a population-based study

Background

Increased in susceptibility to thrombotic disease may be associated with lower lung function. If causal, this association may suggest an area for development of new interventions for lung disease. The aim of this study was to investigate the association between blood coagulation activation as measured by plasma d-dimers and lung function.

Methodology/Principal Findings

We conducted a cross-sectional study on 2463 randomly selected adults in 1991 and followed up 1252 of these individuals in 2000. Plasma D-dimer levels, a marker of activity of blood coagulation pathways, were analysed in the baseline 1991 samples. There was an inverse cross-sectional association between plasma D-dimer and Forced Expiratory Volume in one second, with a decrease of 71 ml per µg FEU/ml increment in plasma D-dimer (95% confidence intervals CI: −135 to −6), and a decrease in Forced Vital Capacity (97 ml per µg FEU/ml increase in D-dimer, 95%CI: −170 to −24). These associations were attenuated after adjustment for serum highly sensitive CRP. No association was observed between plasma D-dimer and the decline in lung function between 1991 and 2000.

Conclusions/Significance

The cross-sectional findings are consistent with the hypothesis that activation of blood coagulation pathways is associated with decreased lung function, and that systemic inflammation may contribute to this relation. However, the lack of an association with decline in lung function suggests that clotting pathways that involve d-dimers may not be a promising therapeutic target for new interventions for respiratory disease.     

Plasma carbonyls do not correlate with lung function or computed tomography measures of lung density in older smokers.

Oxidative stress and inflammation are hallmarks of chronic obstructive pulmonary disease (COPD). A critical byproduct of oxidative damage is the introduction of carbonyl groups into amino acid residues. We hypothesize that plasma carbonyl content is inversely correlated with lung function and computed tomography (CT) measures of lung density among smokers and is elevated in COPD. Carbonyl was measured in plasma of participants aged 60 years and older by ELISA. Generalized linear and additive models were used to adjust for potential confounders. Among 541 participants (52% male, mean age 67 years, 41% current smokers), mean plasma carbonyl content was 17.9+/-2.9 nmol ml(-1) and mean forced expiratory volume in one second (FEV(1)) was 80.7+/-20.9% of predicted. Plasma carbonyl content was inversely associated with FEV(1), but this relationship was largely explained by age. Multivariate analyses ruled out clinically meaningful associations of plasma carbonyl content with FEV(1), FEV(1)/FVC (forced vital capacity) ratio, severity of airflow obstruction, and CT lung density. Plasma carbonyl content is a poor biomarker of oxidative stress in COPD and emphysema.     

Long-term exposure to outdoor VOCs and lung function in urban adults: a cross-sectional study in Tabriz an industrialized city in the northwest of Iran

Abstract

This study aimed to evaluate the effects of outdoor benzene, toluene, xylenes, and styrene (BTXS) on respiratory system performance in adults living in an industrialized city. The concentration of BTXS was measured in the three selected areas (low traffic, high traffic and industrial). Pulmonary function of totally 219 participants who have lived in the selected areas for at least five years, were evaluated through the spiromertry. Based on the results, significant differences were observed between the mean concentrations of BTXS (industrial area?>?high traffic area?>?low traffic area). Considerable decline of 0.46?L, 0.41?L, 2.99%, 0.9?L/min, and 0.59?L/s for Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV₁), FEV₁/FVC, Peak Expiratory Flow (PEF) and Forced Expiratory Flow between 25% and 75% of vital capacity (FEF_25–75%), respectively, were detected in industrial area residents compared to the low traffic region. In addition, some spirometric parameters were different between the other sampling sites. In conclusion, the results showed that the long term exposure to higher concentrations of BTXS increases respiratory dysfunction risks in industrial and high traffic areas respectively, as compared with living in the low traffic region.     

Vital capacity and inspiratory capacity as additional parameters to evaluate bronchodilator response in asthmatic patients: a cross sectional study

ABSTRACT: BACKGROUND: Bronchodilator response in patients with asthma is evaluated based on post-bronchodilator increase in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). However, the need for additional parameters, mainly among patients with severe asthma, has already been demonstrated. METHODS: The aim of this study was to evaluate the usefulness of vital capacity (VC) and inspiratory capacity (IC) to evaluate bronchodilator response in asthma patients with persistent airflow obstruction. The 43 asthma patients enrolled in the study were stratified into moderate or severe airflow obstruction groups based on baseline FEV1. All patients performed a 6-minute walk test before and after the bronchodilator (BD). A bipolar visual analogue scale post-BD was performed to assess clinical effect. The correlation between VC and IC and clinical response, determined by visual analogue scale (VAS) and 6-minute walk test (6MWT), was investigated. RESULTS: Patients in the severe group presented: 1) greater bronchodilator response in VC (48% vs 15%, p = 0.02), 2) a significant correlation between VC variation and the reduction in air trapping (Rs = 0.70; p < 0.01), 3) a significant agreement between VC and VAS score (kappa = 0.57; p < 0.01). There was no correlation between IC and the reduction in air trapping or clinical data. CONCLUSIONS: VC may be a useful additional parameter to evaluate bronchodilator response in asthma patients with severe airflow obstruction.     

Influence of intrinsic sympathomimetic activity on respiratory function during chronic beta blockade: comparison of propranolol and pindolol.

The long term effect of beta blockers and the influence of intrinsic sympathomimetic activity on respiratory function were assessed in patients with chronic stable angina pectoris randomised to receive treatment with propranolol (n = 21) or pindolol (n = 19) for one year. Forced expiratory volume in one second (FEV1) had fallen by a mean of 240 ml after one year (p less than 0.001) in those treated with propranolol compared with 120 ml in those treated with pindolol (p less than 0.05). The difference between the groups was significant (p less than 0.01). Vital capacity fell significantly only in those treated with propranolol (p less than 0.05 at one year). In those in whom the basal ratio of FEV1 to forced vital capacity was low (less than 70%) propranolol, but not pindolol, caused a significant (p less than 0.05) fall in FEV1 throughout treatment. Long term administration of pindolol has a less adverse effect on respiratory function than propranolol, which results in a progressive deterioration in respiratory function over one year.     

ACUTE AND CHRONIC ASTHMA—Treatment with Theophylline in Hydro-Alcoholic Solution: Clinical Evaluation and Pulmonary Function Studies

A flavored solution containing 80 mg. of theophylline and 3 cc. of ethyl alcohol per 15 cc. was given orally to 31 patients with acute asthma to terminate the attack. Thirty patients with moderate to severe chronic asthma were alternated for three or four weeks on daily multiple doses of either the theophylline solution or a placebo.In the acute cases three-second Vital Capacity increased by 33.8 per cent and Maximal Breathing Capacity by 30.2 per cent in one hour after taking 60 cc. to 75 cc. of the theophylline solution. When placebos were given, both measures of lung function declined during the first half hour.Seventy-one and a half per cent of patients with acute cases felt moderate to complete relief of symptoms. In persons with chronic asthma the regular use of the theophylline solution did not change the frequency of asthma in most cases, but it decreased the severity in 59 per cent of cases. The values for three-second Vital Capacity and Maximal Breathing Capacity rose only a little.Gastric irritation was noted in one-third of the chronic cases and one-fourth of the acute cases. This could be reduced by appropriate measures.