小气道功能障碍对老年人大气道功能参数的影响。
Effect of small airway dysfunction on large airway function parameters in elderly adults.
作者信息
Pan Jing, Zheng Yongke, Lin Wen, Chen Hui
机构信息
Department of Geriatrics, Wenzhou Central Hospital of Zhejiang Province/The Second Affiliated Hospital of Shanghai University, Wenzhou, 325000, Zhejiang, China.
Pulmonary Function Laboratory, Wenzhou Central Hospital of Zhejiang Province/The Second Affiliated Hospital of Shanghai University, Wenzhou, 325000, Zhejiang, China.
出版信息
BMC Geriatr. 2025 Apr 22;25(1):262. doi: 10.1186/s12877-025-05935-4.
BACKGROUND
To investigate the effect of simple small airway dysfunction (SAD) on large airway function parameters in old people.
METHODS
Elderly patients aged 60-80 years with complete pulmonary function data including the measured/predicted values of ≥ 80% for each of forced expiratory capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF), and FEV1/FVC ≥ 70% were included. Patients with no known smoking history, normal chest computerized tomography, and the measured/predicted values of ≥ 70% for each of maximal flows at 50% and 25% of remaining FVC (MEF50 and MEF25) and maximum mid-expiratory flow (MMEF) were categorized into the control group, whereas patients with the measured/predicted values of < 65% for more than 2 of MEF50, MEF25, and MMEF were divided into the observation group. 104 patients with simple SAD (observation group) and 102 patients with normal pulmonary function (control group) were selected.
RESULTS
The parameters of small airway function including MEF50, MEF25, and MMEF were positively correlated with slow vital capacity (SVC), FVC, FEV, PEF, and MEF75 in the large airway in both groups (r = 0.280-0.634). Except for PEF, the other 5 parameters in the observation group were significantly different from those in the control group. There was no significant difference between total lung capacity (TLC) and functional residual capacity (FRC), but there were significant differences between residual volume (RV), RV/TLC, diffusion capacity for carbon monoxide (DLCO), and specific diffusing capacity (KCO). There were 66 cases of SVC-FVC > 0 (FVC/SVC < 1) (66/104, 63.46%) in the observation group) and 45 cases of the control group (45/102, 44.12%), and the difference between the two groups was statistically significant. The area under the curve (AUC) of SVC-FVC and FVC/SVC in the prediction of SAD was 0.631 and 0.639, respectively, with a sensitivity and specificity of 63%.
CONCLUSIONS
Simple SAD was associated with large airway pulmonary function, and PEF may not be a suitable parameter for large airway pulmonary function in the old adults. SVC-FVC > 0.02 L had a certain predictive value for SAD in the elderly.
背景
探讨单纯小气道功能障碍（SAD）对老年人大气道功能参数的影响。
方法
纳入年龄在60 - 80岁、肺功能数据完整的老年患者，包括用力肺活量（FVC）、一秒用力呼气容积（FEV1）和呼气峰值流速（PEF）的实测值/预测值≥80%，且FEV1/FVC≥70%。无已知吸烟史、胸部计算机断层扫描正常、残气量（RV）的50%和25%时的最大流速（MEF50和MEF25）及最大呼气中期流速（MMEF）的实测值/预测值≥70%的患者被归入对照组，而MEF50、MEF25和MMEF中超过2项实测值/预测值<65%的患者被分为观察组。选取104例单纯SAD患者（观察组）和102例肺功能正常的患者（对照组）。
结果
两组中小气道功能参数MEF50、MEF25和MMEF与大气道中的慢肺活量（SVC）、FVC、FEV、PEF和MEF75均呈正相关（r = 0.280 - 0.634）。除PEF外，观察组的其他5项参数与对照组有显著差异。肺总量（TLC）和功能残气量（FRC）之间无显著差异，但残气量（RV）、RV/TLC、一氧化碳弥散量（DLCO）和比弥散量（KCO）之间有显著差异。观察组有66例SVC - FVC>0（FVC/SVC<1）（66/104，63.46%），对照组有45例（45/102，44.12%），两组差异有统计学意义。SVC - FVC和FVC/SVC预测SAD的曲线下面积（AUC）分别为0.631和0.639，灵敏度和特异度均为63%。
结论
单纯SAD与大气道肺功能相关，PEF可能不是老年人大气道肺功能的合适参数。SVC - FVC>0.02 L对老年人SAD有一定的预测价值。
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