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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
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