大台北地區國小學童尖峰呼氣流速正常參考值之研究

The Predicted PEFR Normal Reference Data of Elementary School Children in Taipei Area

10.7023/TJFM.200209.0121

徐世達(Shyh-Dar Shyur)；汪正宇(Cheng-Yu Wang)；吳正裕(Cheng-Yu Wu)；趙永康(Yung-Kang Chao)

PEF ； normal reference ； elementary school children ； asthma

台灣家庭醫學雜誌

12卷3期（2002 / 09 / 01）

121 - 128

繁體中文

氣喘病人常會低估個人臨床症狀，並對於疾病嚴重度有不正確的認知，此種現象尤其常見於症狀較嚴重者及長期病史的病童。測量肺功能可較客觀且直接得知病童氣道阻塞的嚴重程度。在不同肺功能的測量裏，以尖峰呼氣流速對氣瑞病的診斷、治療、及疾病的監控上，幫助甚大。目前已有很多研究根據年齡、性別、體重及身高訂定出尖峰呼氣流速之參考值，可以用來判斷急性氣喘發作病人的尖峰呼氣流速值是否正常。不同的族群有不同的尖峰呼氣流速值，故建立本國兒童的正常預測參考值範圍是非常重要的。 在本研究中，我們選取二十所大台北地區的國民小學，每所小學每個年級中任選四個班級，測量學童的尖峰呼氣流速。本研究採用Astech尖峰呼氣流速計來進行尖峰呼氣流速的測試。在測試前由學童家長填寫一份問卷來排除有特殊呼吸道疾病(包括近期有呼吸道感染的臨床症狀者)或是氣喘的學童。最後總共有6,346位學童進入統計，年齡從六歲到十二歲，男生3,058位，女生3,288位。 本研究所建立的大台北地區6至12歲國小學童尖峰呼氣流速(PEF)之正常預測參考值公式如下: 男孩 尖峰呼氣流速預測值=-130.5+9.347653× 年齡(年)+2.033576× 身高(公分)+0.806917× 體重(公斤) 女孩 尖峰呼氣流速預測值=-98.87426+7.37373× 年齡(年)+2.033576× 身高(公分)+0.806917× 體重(公斤)

Patients with asthma frequently have poor recognition of their symptoms and poor perception of the severity, especially if their asthma is severe and longstanding. Measurements of lung function provide direct assessment of airflow limitation. The peak expiratory flows meter is probably the most important innovation to aid in the diagnosis and subsequent treatment of asthma. Predicted values of PEF based on age, gender, weight, and height have been obtained from population studies, and it can be used to judge whether a given value is abnormal or not. It is important to establish normal reference data of PEF for our own children because different ethnic groups have different physics and different values of PEF. In this study, twenty elementary schools in Taipei area were enrolled. Four classes were selected randomly for each grade at every elementary school. The PEF was measured with standing position in the morning. Astech peak flow meter was used in our study. A simple questionnaire for the parents was used to exclude children with asthma and other respiratory diseases. There are 6,346 elementary school children aged 6 to 12 were enrolled, with 3,058 boys and 3,288 girls. In this study, multiple variants regression was used for statistics. Two formulas to predict PEF normal reference data for children aged 6 to 12, girl and boy, respectively were established as fllows: Boys PEFR=-130.5+9.347653A+2.033576H+0.806917W Girls PEFR=-98.87426+7.37373A+1.682135H+1.27746W A : age(year) H :heigh(cm) W :weight(kg)

1. (2002).National Institutes of Health, National Heart, Lung, and Bleed Institute.GINA Revised.
2. Chiang ST,Han TS(1965).Peak flow rate in relation to age, sex and anthropological measurements.Asia Paediatr Scand,54,439-445.
3. Coultas DB,Gong H,Grad R(1994).Respiratory diseases in minorities of the United Staten.Am J Respir Crit Care Med,149,93-131.
4. DeGroodt ES,Quanjer PH,Wise ME,van Zomeren BC(1986).Changing relationships between stature and lung volumes during puberty.Respir Physiol,65,139-153.
5. Dickman ML,Schmidt CD,Gardner RM(1971).Spirometric standards for normal children and adolescents (ages 5 years through 18 years).Am Rev Respir Dis,104,680-687.
6. Godfrey S,Kamburoff PL,Nairn JL(1970).Spirometry, lung volumes and airway resistance in normal children ages 5 to 18 years.Br J Dis Chest,64,15-24.
7. Jackson AC(1995).Accuracy, reproducibility, and variability of portable peak flowmeters.Chest,107,648-651.
8. Lana JE(1965).Respiratory measurements of 3,356 Sheffield schoolchildren.Br J Prev Soc Med,19,115-122.
9. Mathur N,Rastogi SK,Gupta BN,Husain T(1990).A global comparison of predicting equations on spirometry in the male population.Int J Epidemiol,19,331-338.
10. Noirn JR,Bennet AS,Andrew JD,MacArthur P(1961).A study of respiratory function in normal school children: the peak expiratory flow rate.Arch Divs Child,36,253-258.
11. Polgar G,Weng TR(1979).The functional development of the respiratory system: state of the art.Am Rev Respir Dis,120,625-695.
12. Primhak RA,Biggies JD,Tsanakas JN,Hatzmichael A,Milner RDG,Karpouzas JG(1984).Factors affecting the peak expiratory flow rate in children.Br J Dis Chest,78,26-35.
13. Schrader PC,Quanjer PH,van Zomeren BC,Wise ME(1984).Changes in the FEV1-height relationship during pubertal growth.Bull Eur Physiopathol Respir,20,381-388.
14. Schwartz JD,Katz SA,Fegley RW,Tockman MS(1988).Sex and race differences in the development of lung function.Am Rev Respir Dis,136,1415-1421.
15. Smith DW(1977).Growth and Its Disorders: Basics and Standards, Approach And Classification, Growth Deficiency Disorders, Growth Excess Disordres, Obesity.Philadelphia:Saunders.
16. Thurlbeck WM(1982).Postnatal human lung growth.Thorax,37,564-571.
17. Wall MA,Olson D,Bonn TC,Buist AS(1982).Lung function in North American Indian children: reference standards for spirometry, maximal expiratory flow volume corset, and peak expiratory flow.Am Rev Respir Dis,125,158-162.
18. Weng T,Levison H(1969).Standards of pulmonary function in children.Am Rev Respir Dis,99,879-893.
19. Woolcock AJ,Colman MH,Blackburn CR(1972).Factors affecting normal values for ventilatory lung function.Am Rev Respir Dis,106,692-709.
20. 吳家興、林瑞雄、謝貴雄(1998)。台灣北部國中學生氣喘盛行率調查。中華衛教，17，214-225。
21. 謝貴雄。國科會計畫報告。