| Objective:Pulmonary function indices are important reference for clinical diagnosis and prevention of disease, only a unified and accurate reference standard can better help to diagnosis and therapy, thus it is particularly necessary to formulate the normal reference value. Expiratory reserve volume (ERV)and inspiratory capacity (IC) have an important significance in the clinical application of pulmonary function. If expiratory reserve volume and inspiratory capacity are obviously decrease, it shows that there exists serious obstructive ventilation diseases, might cause thoracic expansion to be limited and lung tissue to be damaged seriously and so on. The increased Residual volume (RV) indicates that small airway prematurely closing, such as emphysema and cor pulmonale, etc. Determination of Peak expiratory flow (PEF) can be used to identify treatment is effectived or not, monitor chronic asthma, non-symptoms or athletic asthma and judge whether lung disease is caused by lung or heart disease, and also can be used for early diagnosis and treatment the disease deterioration. That studying these lung function indices quantitatively, is an important basis for clinical diagnosis and prevent disease. That can not only provide scientific basis for clinical testing and lung function damage rating of occupational disease patients, and also give methodology guidance for other medical research. Methods:The innovation of this paper is that, using linear and non-linear methods do research on the relationship between geographical factors and Chinese's Expiratory reserve volume, inspiratory capacity, Residual volume, the maximum of expiratory flows in different age for different gender. Applying kriging method, with the ArcMap module of ArcGIS softwares gets the normal reference of four indices of lung function in healthy people in different age in different region of China. Although many literatures have also reported normal reference value of lung function of the elderly, adults,teenager and children in Lhasa, Xining, Jiangsu, hainan, etc, but they are only qualitative description to the relationship between the reference value and altitude or climate; some researchers have also just determinated local normal value of lung function,others only use simple linear method to study the effect of the single factor on lung function indices. By far, no paper does such systemic study on the relationship between them based on China entire geographical environment. Results:(1)Buying the material through the relevant units or retrieving by manual and network, the normal value of lung function in different region in China are collected, they are as follows:ERV of 2729 healthy adolescent boys, ERV of 2711 healthy adolesent girls, ERV of 8220 healthy younger women, RV of 3744 healthy younger men, IC of 6100 younger men, PEF of 4091 healthy middle-aged men and PEF of 9661 healthy young men in the national regions.(2) According to sharing data from the national surveying and mapping center and related geographical literatures and works, seven geographic indices in 4383 regions are obtained: altitude(X1,m), annual sunshine duration(X2,h), annual mean air temperature(X3,℃),annual mean relative humidity(X4,%),annual precipitation amount(X5,mm), annual range of air temprature(X6,℃)and annual mean wind speed(X7,m/s).(3)By the linear and nonlinear analysis for four indices of lung function with seven geographical factors, build multivariate linear regression model, curve estimation model, and principal component analysis model between them, and then compare different models of each index, choose the optimal prediction model, respectively is as follows:①Principal component analysis model of normal reference value of ERV of adolescent boys: Y ERV=1.658+0.00000692x1+0.0000828x2-0.00563x3-0.00409x4-0.000109x5+0.00452x6-0.0677x7②Curve estimation model of normal reference value of ERV of adolescent girls: YERV=1.662×0.964X3③Multivariate linear regression model of normal reference value of ERV of younger women: YERV=-1.930+0.00013x1+0.00043x2-0.0253x3+0.0375x4-0.075x7④Multivariate linear regression model of normal reference value of RV of younger men: Y RV=3226.156-0.094x1-14.064x4-242.442x7⑤Multivariate linear regression model of normal reference value of IC of younger men: Y IC=1.294-0.051x3+0.019x4+0.023x6⑥Principal component analysis model of normal reference value of PEF of middle-aged and older men: Y PEF=7.845-0.000355x1-0.000120x2+0.00154x3+0.00108x4-0.000130x5+0.0120x6-0.408x7⑦Principal component analysis model of normal reference value of PEF of younger men: Y PEF=7.839+0.000266x1+0.000485x2-0.0135x3-0.0193x4-0.000146x5-0.00951x6-0.119x7(4) According to prediction model and geostatistical analysis method, using the ArcMap module of ArcGIS softwares, loads normal reference value of lung function and attribute value of geographical factors of 4383 regions into the well-vectored map, and then applying the Kriging interpolation method to get spatial distribution map of normal reference value of lung function of four indices respectively.Conclusion:The above model can estimate the Chinese regions different age and different gender's normal reference lung function, it can provide scientific reference standard for clinical medicine and social psychology conveniently, and also can clearly find distribution trend about four indices of lung function from the map. |
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