肺功能的非特异改变值得关注—附20例病例资料报告

发布时间：2018-01-23 11:34

本文关键词： 用力肺活量一秒量一秒率肺功能非特异改变限制性通气功能障碍　出处：《山东大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究目的：分析肺功能非特异改变的肺功能参数特点,探讨其临床意义。研究方法：采用回顾性队列研究的方法,调取山东大学齐鲁医院2013.8.1至2014.2.1期间归档的肺功能检查报告单5259例。纳入标准：①用力肺活量(FVC)及第一秒用力呼气容积(FEV,)下降；②第一秒用力呼气容积占用力肺活量比值(FEV1/FVC)正常；共304例。继之,从中选择具有一氧化碳弥散法或体积描计仪法肺总量(TLC)数据者,共65例。最后,根据受试者TLC正常或降低,分为肺功能非特异改变组(TLC正常,n=20)20例和限制性通气功能障碍组(TLC下降,n=45)45例两组。应用SPSS19.0软件,进行两样本t检验,比较肺功能非特异组和限制性通气功能障碍组,性别、年龄、体重指数(BMI)、吸烟史以及与肺功能参数特点；分析肺功能非特异改变组中包含的疾病种类。研究结果 1.肺功能结果表现为FVC及FEV1下降,FEV1/FVC正常或升高的受试者共304例,占所有肺功能受试者的5.7%,其中65例进行TLC的测定。 2.肺功能非特异改变组和限制性通气功能障碍组相比,年龄、性别、吸烟史及BMI无统计学差异。与限制性通气功能障碍组相比,肺功能非特异改变组的肺活量占预计值百分比(VC%pred)、用力肺活量占预计值百分比(FVC%pred),第一秒用力呼气容积占预计值的百分比(FEV,%pred)、残气量占预计值百分比(RV%pred)、肺总量占预计值百分比(TLC%pred)、残总比(RV/TLC)较高,均有统计学差异(P0.05)。肺功能非特异改变组的最显著特点为残气量(RV)及RV/TLC增加,其中有56.5%的受试者表现为RV升高,78.3%的受试者表现为RV/TLC升高。 3.肺功能非特异改变组的临床诊断包括支气管哮喘10例；慢性支气管炎3例；支气管扩张症2例；间质性肺疾病2例；脊髓侧索硬化症1例；诊断不明确2例。最常见的疾病为支气管哮喘。结论： 1.表现为FVC及FEV1下降,FEV1/FVC正常的肺功能结果类型并不少见,临床医生应提起关注。 2.导致肺功能的非特异改变的疾病主体,既包括阻塞性疾病也包括限制性疾病。最常见的疾病为支气管哮喘。 3.肺功能结果表现为FVC及FEV1下降,FEV1/FVC正常时,需进一步测定TLC。
[Abstract]:Objectives of the study: To analyze the characteristics of pulmonary function parameters in non-specific changes of lung function and to explore its clinical significance. Research methods: Retrospective cohort study was used. 5259 cases of lung function examination report filed in Qilu Hospital, Shandong University from 8.1 to 2014.2.1. FVC was included in the standard of forced vital capacity (FVC). Forced expiratory volume and FEV at 1 second. ) decline; 2the ratio of forced expiratory volume occupancy and FEV1 / FVCwas normal at 1 second; A total of 304 cases were followed by 65 patients who had carbon monoxide dispersion or volumetric instrument data. Finally, the TLC was normal or decreased according to the subjects. The patients were divided into two groups: 20 patients with normal TLC and 45 patients with restrictive ventilation dysfunction. SPSS19.0 software was used. Two t-test samples were performed to compare the characteristics of lung function nonspecific group and restrictive ventilation dysfunction group, sex, age, body mass index (BMI), smoking history and pulmonary function parameters. The types of diseases included in non-specific changes in lung function were analyzed. Research results 1. There were 304 subjects with normal or elevated FEV1 / FVC in FVC and FEV1, accounting for 5.7% of all pulmonary functional subjects. TLC was measured in 65 cases. 2. There were no significant differences in age, sex, smoking history and BMI between non-specific pulmonary function change group and restrictive ventilation dysfunction group. The vital capacity of the patients with nonspecific changes in lung function was as a percentage of the predicted value, and the forced vital capacity as a percentage of the predicted value was higher than that of the control group (FVCpredd). 1 second forced expiratory volume as a percentage of expected value FEV predder, residual volume as percentage of predicted value RV predd, total lung volume as percentage of predicted value TLCpred). The residual total was higher than that of RV / TLC, and there was statistical difference (P 0.05). The most significant feature of non-specific changes in lung function was the increase of residual volume (RV) and RV/TLC. 56.5% of the subjects showed elevated RV and 78. 3% showed elevated RV/TLC. 3. 10 cases of bronchial asthma were included in the clinical diagnosis of nonspecific changes in lung function. 3 cases of chronic bronchitis; Bronchiectasis 2 cases; 2 cases of interstitial pulmonary disease; 1 case of lateral sclerosis of spinal cord; The diagnosis was unclear in 2 cases. The most common disease was bronchial asthma. Conclusion: 1. The type of normal pulmonary function with FVC and FEV1 decreased and FEV1 / FVC is not uncommon. Clinicians should pay attention to it. 2. The main body of disease that causes nonspecific changes in lung function, both obstructive and restrictive. The most common disease is bronchial asthma. 3. The results of pulmonary function showed that FVC and FEV1 decreased and FEV 1 / FVC was normal, TLC should be measured further.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R56

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