墨西哥西班牙裔的DLNO和DLCO的参考方程:海拔和种族的影响
Laura Gochicoa-Rangel1,2, Ada De-Los-Santos-Martínez1, Alejandro Reyes-García1
1Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.
生活在高海拔地区的墨西哥西班牙裔人对氧化 (DLNO) 和一氧化碳 (DLCO) 的肺扩散能力更高. 特定于种族的方程对于准确的肺功能评估至关重要,与种族中立模型相比,减少错误.
科学领域:
- 肺部生理学 肺部生理学
- 高空医学是一种高度医学.
- 呼吸系统诊断 呼吸系统诊断
背景情况:
- 评估肺扩散能力 (DLCO和DLNO) 对呼吸系统健康至关重要.
- 现有的参考方程可能不能准确地反映多样化的人口,包括不同高度的墨西哥西班牙裔.
- 高度和种族可以影响肺功能参数.
研究的目的:
- 为了比较墨西哥西班牙裔的高海拔地区与海平面的氧化 (DLNO) 和一氧化碳 (DLCO) 的肺扩散能力.
- 评估种族特异性与种族中立性参考方程在最小化DLNO和DLCO的误差 (RMSE) 中的有效性.
- 评估种族作为肺功能参考方程中的共同变量的影响.
主要方法:
- 在392名墨西哥西班牙裔和1056名白人受试者中测量了DLNO,DLCO,气膜体积 (VA) 和气体转移系数 (KNO,KCO).
- 开发了使用细分和多重线性回归的参考方程,并通过LASSO验证.
- 使用交叉验证和随机森林,比较种族特定和种族中立模型之间的根平均平方误差 (RMSE).
主要成果:
- 高海拔的墨西哥西班牙裔 (中部地区) 与海平面低地人相比显示出更高的DLCO,DLNO和VA.
- 与种族中立模型相比,种族特定的模型显著降低了DLNO,DLCO和KNO的RMSE.
- 种族中立方程式导致墨西哥西班牙裔的假阳性率更高,而白人则出现假阴性率更高.
结论:
- 居住在高海拔地区的墨西哥西班牙裔人士表现出增强的DLCO和DLNO.
- 将种族纳入参考方程可以提高准确性,降低RMSE并减少错误阳性/负率.
- 高度和种族特定的参考方程对于在不同人群中精确的肺功能测试至关重要.
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