Enright P L, Kronmal R A, Manolio T A, Schenker M B, Hyatt R E
Cardiovascular Health Study Coordinating Center, Seattle, Washington 98105.
Am J Respir Crit Care Med. 1994 Feb;149(2 Pt 1):430-8. doi: 10.1164/ajrccm.149.2.8306041.
Maximal inspiratory pressure (MIP) was assessed in 4,443 ambulatory participants of the Cardiovascular Health Study, 65 yr of age and older, sampled from four communities. Maximal expiratory pressure (MEP) was also measured in 790 participants from a single clinic. Positive predictors of MIP included male sex, FVC, handgrip strength, and higher levels of lean body mass (or low bioelectric resistance). Negative predictors were age, current smoking, self-reported fair to poor general health, and waist size. Both participant and technician learning effects were noted, but there was no independent effect of race, hypertension, cardiovascular disease, or diabetes. A healthy subgroup was identified by excluding current smokers, those with fair to poor general health, or an FEV1 less than 65% of predicted. Mean values determined from the healthy group were 57/116 cm H2O (MIP/MEP) for women, and 83/174 for men. Lower limits of the normal range (fifth percentiles) were 45 to 60% of the mean predicted values. The reference equations derived from this group of healthy 65 to 85-yr-olds may be used by pulmonary function laboratories and respiratory therapists who evaluate the respiratory muscle strength of elderly patients.
在心血管健康研究中，从四个社区抽取了4443名65岁及以上的门诊参与者，评估了他们的最大吸气压力（MIP）。还对来自单一诊所的790名参与者测量了最大呼气压力（MEP）。MIP的正向预测因素包括男性、用力肺活量（FVC）、握力以及较高水平的瘦体重（或低生物电阻）。负向预测因素为年龄、当前吸烟、自我报告的一般健康状况为中等至较差以及腰围。观察到了参与者和技术人员的学习效应，但种族、高血压、心血管疾病或糖尿病并无独立影响。通过排除当前吸烟者、一般健康状况中等至较差者或第一秒用力呼气容积（FEV1）低于预测值65%的人，确定了一个健康亚组。健康组确定的平均值为女性57/116厘米水柱（MIP/MEP），男性83/174。正常范围下限（第五百分位数）为平均预测值的45%至60%。评估老年患者呼吸肌力量的肺功能实验室和呼吸治疗师可以使用从这组65至85岁健康人群得出的参考方程。
