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第45卷第4期 王诗绮,陈幼花,徐小俊,等. 一种基于肺量计构建的慢性阻塞性肺疾病患者过度充气预测
2025年4月 模型[J]. 南京医科大学学报(自然科学版),2025,45(4):535-543,559 ·539 ·
表2 COPD过度充气组和非过度充气组的临床资料比较
Table 2 Comparison of clinical data between the hyperinflation group and the non⁃hyperinflation group in COPD
2
Clinical data Hyperinflation group(n=39) Non⁃hyperinflation group(n=62) Z/χ /t P
QoL parameters
mMRC[scores,M(P25,P75 )] 2.00(1.00,2.00) 1.00(1.00,2.00) -1.959 0.050
mMRC≥2[n(%)] 22(56.41) 20(32.26) 5.749 0.016
CAT[scores,M(P25,P75 )] 10.00(5.00,14.50) 7.00(3.00,17.50) -1.093 0.274
CAT≥10[n(%)] 24(61.54) 21(33.87) 7.419 0.006
GOLD subgroup[n(%)] 6.249 0.044
A 12(30.77) 13(20.97)
B 17(43.59) 42(67.74)
E 10(25.64) 7(11.29)
Professional farmer[n(%)] 13(35.14) 6(9.68) 8.807 0.003
Inhaled medication[n(%)] 0.036 0.849
Ⅰ 18(48.65) 33(53.23)
Ⅱ 19(51.35) 29(46.77)
Spirometer parameters
VC(L,x ± s) 2.51 ± 0.60 3.34 ± 0.51 -7.458 < 0.001
VC%pred[%,M(P25,P75 )] 86.00(83.85,90.80) 88.55(84.70,93.30) -1.646 0.100
MMEF[L/s,M(P25,P75 )] 0.59(0.47,0.71) 0.91(0.69,1.12) -5.637 < 0.001
MMEF%pred(%,x ± s) 23.05 ± 6.480 30.34 ± 7.20 -5.144 < 0.001
PEF(L/s,x ± s) 3.54 ± 1.33 5.09 ± 1.23 -5.948 < 0.001
PEF%pred(%,x ± s) 55.41 ± 16.45 67.49 ± 14.89 -3.812 < 0.001
PIF[L/s,M(P25,P75 )] 2.86(2.26,3.73) 4.20(3.62,4.90) -4.775 < 0.001
MVV[L/min,M(P25,P75 )] 51.30(45.88,60.77) 79.47(68.29,88.79) -6.187 < 0.001
MVV%pred[%,M(P25,P75 )] 58.30(53.20,68.10) 73.55(66.20,80.12) -4.513 < 0.001
Lung fractional volume parameters
RV[L,M(P25,P75 )] 3.59(3.17,4.38) 2.34(2.13,2.60) -7.202 < 0.001
RV%pred[%,M(P25,P75 )] 157.30(130.50,188.05) 92.60(85.65,103.70) -8.123 < 0.001
TLC[L,M(P25,P75 )] 5.60(4.71,6.72) 5.42(4.88,5.84) -0.882 0.378
TLC%pred[%,M(P25,P75 )] 102.80(90.05,115.60) 83.70(79.25,89.60) -5.713 < 0.001
RV/TLC[%,M(P25,P75 )] 64.64(61.94,68.00) 43.50(40.93,46.41) -8.430 < 0.001
RV/TLC%pred[%,M(P25,P75 )] 153.50(141.85,159.90) 108.80(103.03,112.68) -8.430 < 0.001
FRC[L,M(P25,P75 )] 4.22(3.40,4.78) 3.08(2.63,3.44) -4.890 < 0.001
FRC%pred[%,M(P25,P75 )] 132.70(105.60,158.70) 89.30(77.55,101.60) -6.878 < 0.001
IC(L,x ± s) 1.53 ± 0.50 2.31 ± 0.60 -6.774 < 0.001
IC/TLC(x ± s) 0.27 ± 0.08 0.43 ± 0.09 -8.907 < 0.001
Lung diffusion parameters
DLCO%pred(%,x ± s) 57.01 ± 15.80 58.30 ± 16.27 -0.423 0.675
KCO%pred(%,x ± s) 70.03 ± 18.19 75.93 ± 22.75 -1.365 0.175
QoL:quarlity of life;PEF%pred:peak expiratory flow of predicted;TLC:total lung capacity;RV/TLC:residual volume to total lung capacity ratio;
IC/TLC:inspiratory capacity tototal lung capacity ratio;DLCO%pred:diffusing capacity of the lungs for carbon monoxide of predicted.
步回归(后向)选出赤池信息准则(Akaike informa⁃ 患者伴过度充气的独立预测因素(P < 0.01,表3)。
tion criterion,AIC)最小的模型进入多因素 Logistic 2.4 COPD伴过度充气预测因素列线图模型的构建
回归分析,该模型AIC为84.0。结果显示,VC(β=-2.636, 与验证
OR=0.072,95% CI:0.022~0.232)和 MMEF% pred 基于多因素 Logistic 回归模型构建预测 COPD
(β=-0.147,OR=0.863,95%CI:0.790~0.944)是COPD 过度充气的列线图模型(图 3)。该列线图模型预

