补呼气量、残气量、深吸气量及最大呼气流速参考值的地理分布

发布时间：2018-06-02 22:46

本文选题：地理因素 + 参考值　；参考：《陕西师范大学》2010年硕士论文

【摘要】： 目的：肺功能指标是临床诊断和预防疾病的重要参考依据,只有拥有一套准确的统一参考标准,才能更好地进行诊断和治疗,因此制定肺功能各项指标的参考值就显得尤为重要。补呼气量和深吸气量在肺功能临床应用上具有很重要的意义,若补呼气量与深吸气量明显减小,则说明存在严重阻塞性通气疾病,有可能存在胸廓扩张受限的疾病,肺组织受到严重损害等。残气量增加,则表现为小气道过早闭合等肺气肿、肺心病。最大呼气流速的测定不仅可以鉴别治疗是否有效,监测慢性哮喘、无症状哮喘、运动性哮喘和是否为肺源性或心源性的肺部疾病,还可以用来进行病情恶化的早期诊断与治疗。定量的测定研究这些肺功能指标,是临床诊断和预防疾病的重要依据,不仅可以为临床检验提供科学的参考依据,为职业病患者的肺功能损害评级提供依据,还可以指导相关医学的研究进行方法论研究。方法：本论文的创新之处是能定量的从地理环境因素着手,运用线性和非线性的方法对比研究不同年龄不同性别中国人补呼气量、深吸气量、残气量及最大呼气流速与地理环境因素的关系；运用克里格(Kringing)方法,借助ArcGIS软件中的ArcMap模块内插出中国各个地区不同年龄段的男女性健康人肺功能四项指标参考值。不少文献也报道过拉萨、西宁、江苏及海南等地的老年人、成年人及少年儿童肺功能的正常参考值,但都只是定性地描述某个地区对应的参考值与海拔或者气候有一定的关系,或者个别研究人员有限地测定了当地健康人的肺功能正常值；还有学者运用线性的方法,研究了单一因素对肺功能指标的影响,像本论文这样对肺功能四项指标正常参考值与地理因素进行专题系统的以中国整个地域环境为背景研究他们之间关系的还未见报道。结果：(1)通过向相关单位购买或者手工及网络检索大量的文献资料,收集了全国各地区的肺功能正常值,分别为：青春期男性补呼气量2729例、青春期女性补呼气量2711例、青年女性补呼气量8220例、青年男性残气量3744例、青年男性深吸气量6100例、中老年男性最大呼气峰值流速4091例和青年男性最大呼气峰值流速9661例。(2)根据国家测绘中心提供的共享资料、相关地理典著和文献,收集了全国4383个市县地区的七项地理指标：海拔高度(X1,m)、年日照时数(X2,h)、年平均气温(X3,℃)、年平均相对湿度(X4,%)、年降水量(X5,mm)、气温年较差(X6,℃)、年平均风速(X7,m／s)。(3)对肺功能四项指标与七项地理因素进行线性和非线性的分析研究,建立它们之间的多元线性回归模型,曲线估计模型和主成分分析模型。通过各个模型的对比研究,寻找出各个指标的最优预测模型,分别为： ①青春期男性补呼气量参考值的主成分分析模型：Y ERV=1.658+0.00000692x1+0.0000828x2-0.00563x3-0.00409x4-0.000109x5+0.00452x6-0.0677x7 ②青春期女性补呼气量参考值与地理因素的曲线估计模型：Y ERV=1.662×0.964X3 ③青年女性补呼气量参考值与地理因素的多元线性回归模型：Y ERV=-1.930+0.00013x1+0.00043x2-0.0253x3+0.0375x4-0.075x7 ④青年男性残气量参考值与地理因素的多元线性回归模型：Y RV=3226.156-0.094x1-14.064x4-242.442x7 ⑤青年男性深吸气量参考值与地理因素的多元线性回归模型：Y IC=1.294-0.051X3+0.019X4+0.023X6 ⑥中老年男性最大呼气峰值流速参考值与地理因素的主成分分析模型：Y PEF=7.845-0.000355x1-0.000120x2+0.00154x3+0.00108x4-0.000130x5+0.0120x6-0.408x7 ⑦青年男性最大呼气峰值流速参考值与地理因素的主成分分析模型：Y PEF=7.839+0.000266x1+0.000485x2-0.0135x3-0.0193x4-0.000146x5-0.00951x6-0.119x7 (4)运用预测模型和地统计分析方法,借助ArcGIS软件中的ArcMap模块,在已经矢量化好的地图上加载中国4383个地区的肺功能参考值和对应的地理属性值,通过克里格(Kringing)法插值出肺功能四项指标的参考值的空间趋势分布图。结论：通过以上的模型可以估算出整个中国各个地区不同年龄男女性的肺功能参考值,给临床检验医学和社会心理医学带来科学便捷的参考标准,并可以在分布图上清楚地看出肺功能四项指标分布趋势走向及分布规律。
[Abstract]:Objective: the pulmonary function index is an important reference for the diagnosis and prevention of the disease. Only with a set of accurate unified reference standard can the diagnosis and treatment be better. Therefore, it is very important to make the reference value of all the indexes of lung function. The amount of supplemental breath and deep suction is very important in the clinical application of lung function. Significance, if the amount of expiration and deep breathing decreased obviously, it shows that there is a severe obstructive ventilation disease, there may be a disease with limited thoracic dilatation, serious damage to the lung tissue, and so on. The increase of residual gas is the result of premature closure of the airway and other emphysema and pulmonary heart disease. Monitoring chronic asthma, asymptomatic asthma, exercise-induced asthma, and whether it is a pulmonary or cardiogenic lung disease, can also be used for early diagnosis and treatment of disease deterioration. Quantitative determination of these pulmonary function indicators is an important basis for clinical diagnosis and prevention of disease. It can not only provide scientific reference for clinical examination. The basis of this paper is to provide a basis for the assessment of the pulmonary function damage of the patients with occupational disease and to guide the research of the related medicine. The relationship between the residual gas volume and the maximum expiratory flow rate and the geographical and environmental factors; using the Craig (Kringing) method and the ArcMap module in the ArcGIS software to insert the reference value of four indexes of the lung function of male and female healthy people of different ages in different regions of China. Many literature also reported the elderly in Lhasa, Xining, Jiangsu and Hainan, The normal reference value of lung function in adults and children is only a qualitative description of the corresponding reference values in a certain area with a certain relationship with altitude or climate, or a few researchers have limited the normal value of the lung function of the local healthy people; and some scholars have used a linear method to study the single factor on the lung function. The influence of the index, like this paper, the relationship between the normal reference value of the four indexes of lung function and the geographical factors to study the relationship between them in the context of China's whole region has not yet been reported. Results: (1) collecting the whole country through the purchase of the related units or the retrieval of a large number of documents by hand and the network. The normal value of lung function in the area was: 2729 cases of puberty male supplementation, 2711 cases of puberty female, 8220 young women, 3744 young men, 6100 young men, 4091 cases of maximum peak expiratory flow in middle-aged and old men and 9661 cases of maximum peak expiratory flow rate in young men. (2) root. According to the shared data provided by the national surveying and Mapping Center, seven geographical indexes in 4383 cities and counties of the country were collected, including X1 (m), annual sunshine hours (X2, H), annual mean temperature (X3, c), annual mean relative humidity (X4,%), annual precipitation (mm), temperature annual range (X6, c), average annual wind speed (X7, M / s). (3) (3) The four indexes of lung function and seven geographical factors are analyzed and studied linearly and nonlinear. The multiple linear regression model, the curve estimation model and the principal component analysis model are established, and the optimal prediction models for each index are found through the comparison of each model.
The principal component analysis model of the reference value of the puberty male expiratory volume: Y ERV=1.658+0.00000692x1+0.0000828x2-0.00563x3-0.00409x4-0.000109x5+0.00452x6-0.0677x7
2. The estimation model of reference volume and geographical factors for puberty women: Y ERV=1.662 * 0.964X3
(3) the multiple linear regression model of the reference volume of young women's expiratory volume and geographical factors: Y ERV=-1.930+0.00013x1+0.00043x2-0.0253x3+0.0375x4-0.075x7
(4) multiple linear regression model for the reference value of young men's residual volume and geographical factors: Y RV=3226.156-0.094x1-14.064x4-242.442x7
A multiple linear regression model for reference value of young men's deep inspiration and geographical factors: Y IC=1.294-0.051X3+0.019X4+0.023X6
The principal component analysis model of maximum peak expiratory flow rate and geographical factors in middle-aged and old men: Y PEF=7.845-0.000355x1-0.000120x2+0.00154x3+0.00108x4-0.000130x5+0.0120x6-0.408x7
The principal component analysis model of maximum peak expiratory flow velocity of young men and geographical factors: Y PEF=7.839+0.000266x1+0.000485x2-0.0135x3-0.0193x4-0.000146x5-0.00951x6-0.119x7
(4) using the prediction model and the method of geostatistical analysis, with the help of the ArcMap module in ArcGIS software, the reference values of lung function and corresponding geographical attributes of 4383 regions of China are loaded on the vectored maps, and the spatial trend distribution map of the reference values of four indexes of lung function is interpolated by Craig (Kringing) method.
Conclusion: the above model can be used to estimate the pulmonary function reference value of male and female sex in the whole area of China, and bring scientific and convenient reference standard for clinical laboratory medicine and social psycho medicine, and can clearly see the trend and distribution of the four indexes of lung function in the distribution map.
【学位授予单位】：陕西师范大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R188

【参考文献】