基于呼吸量实测的儿童呼吸量估算方法比较研究

呼吸量是人与空气相关暴露评价和健康风险评估的重要参数之一，也是暴露评价和健康风险评估结果科学性、准确性的主要决定性因素.为评估儿童呼吸量估算模型，该研究以甘肃省某县儿童为调查对象，采用问卷调查和现场实测相结合的方式获得了调查地区儿童及其家庭的社会经济状况，以及身高、体重、心率和呼吸量等生理参数，基于7种呼吸量估算模型估算了该县儿童的呼吸量，利用Bland-Altman模型的一致性进行分析，通过实测值对模型的准确性进行了评估，并利用推荐模型基于蒙特卡洛模拟估算了调查区县儿童呼吸量.结果表明:①各估算模型计算出的呼吸量差异显著，基于能量代谢法的呼吸量估算模型计算结果符合儿童生长发育规律，心率回归法不适合儿童呼吸量估算，其估算的6~ < 9岁儿童呼吸量大于其他年龄段.②Bland-Altman模型分析结果表明，Shizgal-Rosa法与心率回归法的一致性较差，各模型落在95%一致性界限外的样本数均小于5%.③与实测值相比，基于Shizgal-Rosa法的能量代谢模型准确性最好，其平均偏差和标准化分数误差分别为0.08 L/min和14%.④基于Shizgal-Rosa法获得调查地区6~ < 9岁、9~ < 12岁和12~ < 15岁男童长期呼吸量分别为9.52、12.35和14.54 m3/d，均略低于推荐值（10.50、13.50和14.60 m3/d）；女童为10.04、12.46和11.99 m3/d，均略高于推荐值（9.30、12.20和11.20 m3/d）.研究显示，相较于目前我国能量代谢法使用的基础代谢率计算公式，采用Shizgal-Rosa法估算调查县儿童呼吸量更为准确，我国亟需开展儿童呼吸量估算模型的更新. 

Comparative Study of Inhalation Rate Estimation Methods in Children

Inhalation rate is one of the important parameters for evaluating air exposure and assessing health risk, and is the main determinant of accurate scientific expose evaluation and health risk assessment results. To evaluate the pediatric inhalation rate estimation models, a questionnaire survey and field measurements were conducted to investigate physiological parameters such as height, weight, heart rate, and inhalation rate of children in a county in Gansu Province, China. The results of seven models for estimating inhalation rates were analyzed. A Bland-Altman analysis was performed to assess the consistency of the seven models, and the inhalation rate was estimated based on Monte Carlo simulation. The results showed that the inhalation rate calculated by the estimation models varied substantially. The results of the model based on the method of energy metabolism were per the growth and development of children. The results of the heart rate regression model showed that inhalation rate in the 6- < 9 age group was greater than those of other age groups, suggesting that heart rate regression is not suitable for estimating inhalation rate of children. The results of the Bland-Altman analysis showed that the proportion of the samples for each model falling outside the 95% consistency limit was less than 5%. The results using the 95% consistency limit showed that the Shizgal-Rosa method had poor consistency with the heart rate regression method. Compared with measured values, the Shizgal-Rosa method had the best accuracy, with an average deviation of 0.08 L/min and a standardized fraction error of 14%. For the Shizgal-Rosa method, the long-term inhalation rate of boys aged 6- < 9, 9- < 12, and 12- < 15 was lower than the recommended values (10.50, 13.50 and 14.60 m3/d), with an average of 9.52, 12.35 and 14.54 m3/d, respectively. The long-term inhalation rate of girls was higher than the recommended values (9.30, 12.20 and 11.20 m3/d), with an averaging 10.04, 12.46 and 11.99 m3/d, respectively. Compared with the basal metabolic rate formula currently used in the energy metabolism method, the Shizgal-Rosa method is more accurate in estimating the inhalation rate of children in the surveyed county. The results of this study indicate that there is an urgent need to update the model used to estimate inhalation rate of Chinese children.