Spirometry in early childhood in cystic fibrosis patients
Spirometry in early childhood in cystic fibrosis patients
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DOI：
10.1378/chest.06-1351
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发表时间：
2007-02-01
期刊：
影响因子：
9.6
通讯作者：
Augarten, Arie
中科院分区：
文献类型：
--
作者：
Vilozni, Daphna;Bentur, Lea;Augarten, Arie
背景：儿童早期囊性纤维化（CF）患者的肺活量测定数据很少，肺活量测定法检测气道阻塞的能力值得商榷。目的：评价肺活量测定法对早期CF患者气流阻塞的检测能力。方法：从5个CF中心招募临床状况稳定的CF儿童（年龄范围为2.5 ~ 6.9岁）。儿童进行引导肺活量测定（SpiroGame； Vilzone博士2003年获得专利）。将肺活量测定指标与健康幼儿人群的数值进行比较，并分析其与年龄、性别和临床参数（基因型、胰腺状况、痰液或口咽培养中假单胞菌的存在）的关系。结果：93例患儿中76例肺量测定合格。FVC、FEV1、0.5 s用力呼气流量（FEV0.5）、50%肺活量用力呼气流量（FEF50）显著低于健康组（z评分，平均+/- SD分别为- 0.36 +/- 0.58、- 0.36 +/- 0.72、- 1.20 +/- 0.87、- 1.80 +/- 1.47,p < 0.01）；FEV1和FVC的z分数在研究的年龄范围内相似。然而，与年龄较小的儿童相比，年龄较大的儿童的FEV1和用力呼气流量在25 - 75%的肺活量时的z评分明显较低（p < 0.001）， 6岁儿童的z评分低于平均值的比例高于3岁儿童（65%比5%，p < 0.03）。女生FEF50低于男生（z分数：- 2.42 +/- 1.91 vs . - 1.56 +/- 1.23; p < 0.001）。临床参数评估未发现影响肺量测定指标。结论：儿童早期CF患者肺活量测定可作为一种重要的无创肺状态监测工具。在检测和描述儿童早期肺功能变化方面，FEV0.5和流量相关体积可能比传统的FEV1更敏感。
Background: Spirometry data in cystic fibrosis (CF) patients in early childhood is scarce, and the ability of spirometry to detect airways obstruction is debatable. Objective: To evaluate the ability of spirometry to detect airflow obstruction in CF patients in early childhood.Methods: CF children (age range, 2.5 to 6.9 years) in stable clinical condition were recruited from five CF centers. The children performed guided spirometry (SpiroGame; patented by Dr. Vilzone, 2003). Spirometry indices were compared to values of a healthy early childhood population, and were analyzed with relation to age, gender, and clinical parameters (genotype, pancreatic status, and presence of Pseudomonas in sputum or oropharyngeal cultures).Results: Seventy-six of 93 children tested performed acceptable spirometry. FVC, FEV1, forced expiratory flow in 0.5 s (FEV0.5), and forced expiratory flow at 50% of vital capacity (FEF50) were significantly lower than healthy (z scores, mean +/- SD: - 0.36 +/- 0.58, - 0.36 +/- 0.72, - 1.20 +/- 0.87; and - 1.80 +/- 1.47, respectively; p < 0.01); z scores for FEV1 and FVC were similar over the age ranges studied. However, z scores for FEV1, and forced expiratory flow at 25 to 75% of vital capacity were significantly lower in older children compared to younger children (p < 0.001), and a higher proportion of 6-year-old than 3-year-old children had z scores that were > 2 SDs below the mean (65% vs 5%, p < 0.03). Girls demonstrated lower FEF50 than boys (z scores: - 2.42 +/- 1.91 vs; - 1.56 +/- 1.23; p < 0.001). Clinical parameters evaluated were not found to influence spirometric indices.Conclusions: Spirometry elicited by CF patients in early childhood can serve as an important noninvasive tool for monitoring pulmonary status. FEV0.5 and flow-related volumes might be more sensitive than the traditional FEV1 in detecting and portraying changes in lung function during early childhood.