Morales P, Sanchis J, Cordero P J, Díez J L
Servicio de Neumología, Hospital Universitario La Fe, Valencia.
Arch Bronconeumol. 1997 May;33(5):213-9. doi: 10.1016/s0300-2896(15)30609-8.
The aim of this study was to establish reference values for PImax and PEmax for the Mediterranean adult population. Male and female individuals between 18 and 83 years old meeting the criteria for consideration as references and residing in the metropolitan area of Valencia were assigned by decades to six subgroups, each containing at least 20 men and 20 women. PEmax was obtained from the point of maximum expiration (residual volume) and PImax was the point of maximum inspiration (total lung capacity). The cohort, which finally included 264 subjects (129 men and 135 women), was separated a priori by sex for data analysis. The following types of variables were studied: sociological (employment, educational level and exercise), biometric (age, height and weight) and spirometric results. A linear correlation analysis was performed for each pair of variables and a Kolmogorov-Smirnov test of normality was performed. In order to check the accuracy of PImax and PEmax readings, intra-individual variability was determined by performing three consecutive procedures over 3 days in 39 randomly selected individuals (18 men and 21 women). Significant inter-day and inter-test effects for respiratory pressures were thus ruled out. Predictive equations were worked out using a simple linear model including all predictive variables and eliminating weaker variables in a stepwise manner. Mathematical goodness of fit was assessed by a coefficient for multiple determinations (R2); also determined were the estimated standard error and statistical significance. We also compared observed and estimated values and the behavior of residual values in terms of their independence, normality and homoscedasticity. Reference limits were established by defining percentiles. The equations finally arrived at for men were as follows: PImax (-cmH2O) - 1.03 x Age + 0.59 x Weight + 133.07, PEmax (cmH2O) - 1.31 x Age + 263.12. The equations for women were PImax (-cmH2O) - 0.64 x Age + 125.18, PEmax (cmH2O) - 0.57 x Age + 0.65 x Weight + 116.26. Agreement with the usual references (the Black and Hyatt equations) was analyzed.
本研究的目的是确定地中海成年人群体的最大吸气压（PImax）和最大呼气压（PEmax）的参考值。将居住在瓦伦西亚大都市区、年龄在18至83岁之间、符合作为参考标准的男性和女性个体按年龄段分为六个亚组，每组至少有20名男性和20名女性。PEmax是从最大呼气点（残气量）获得的，PImax是最大吸气点（肺总量）。最终纳入264名受试者（129名男性和135名女性）的队列，在数据分析前按性别进行了预先分组。研究了以下类型的变量：社会学变量（就业、教育水平和运动情况）、生物统计学变量（年龄、身高和体重）以及肺量计测量结果。对每对变量进行了线性相关分析，并进行了Kolmogorov-Smirnov正态性检验。为了检验PImax和PEmax读数的准确性，对39名随机选择的个体（18名男性和21名女性）在3天内进行了连续三次测量，以确定个体内变异性。由此排除了呼吸压力的显著日间和测试间效应。使用包含所有预测变量的简单线性模型，并逐步剔除较弱的变量，得出预测方程。通过多重决定系数（R2）评估数学拟合优度；还确定了估计标准误差和统计显著性。我们还比较了观察值和估计值，以及残差在独立性、正态性和同方差性方面的表现。通过定义百分位数来确定参考限值。最终得出的男性方程如下：PImax（-cmH2O）=-1.03×年龄+0.59×体重+133.07，PEmax（cmH2O）=-1.31×年龄+263.12。女性方程为PImax（-cmH2O）=-0.64×年龄+125.18，PEmax（cmH2O）=-0.57×年龄+0.65×体重+116.26。分析了与常用参考值（Black和Hyatt方程）的一致性。
