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[哮喘儿童生长预后的调查]

[Investigation of growth prognosis in asthmatic children].

作者信息

Baum W F, Kosubek F B, Schneyer U, Klöditz E

机构信息

Universitätsklinik und Poliklinik für Kinder- und Jugendmedizin, Germany.

出版信息

Pneumologie. 2002 Mar;56(3):176-81. doi: 10.1055/s-2002-20554.

Abstract

The objective of the present study was the ascertainment of correct data related to growth prognosis in asthmatic children. For this purpose, 210 young asthmatics including 153 males and 57 females ranging in age from 1.7 to 18.9 years were evaluated. Data were specified for the parameters: chronological age (CA); bone age (KA); height age (LA); height (KH); severity of illness; target adult height (GZG) and predicted adult height (PEG). Among this group, 5.9 % of the boys and 3.5 % of the girls, were found to be of small stature (KH < - 2 s). This corresponds to about 2.5 and 1.5 times the average in a normal distribution. Children with the highest severity of illness showed the strongest negative deviation for the KH-SDS values (boys - 0.59 plus minus 1.1, girls - 0.97 plus minus 0.8). This proved to be statistically significant for females. Development of CA, KA and LA continued unremarkably until the age of 4 years. From age 5, partially a significant growth retardation of KA and LA could be observed in both sexes. To age 16, KA values and, after that LA values, were more strongly affected. Comparison of the GZG and PEG average values within the degree of severity groups made it clear that the PEG values for both sexes, independent of the severity of illness, were without exception, smaller than the GZG. The differences of both parameters proved to be statistically significant for the group with the most severe symptoms of the boys (180.8 plus minus 6.5 cm to 175.8 plus minus 6.2 cm, p < 0.01) and for the entire groups of both sexes (boys 180.2 plus minus 5.3 cm to 178.6 plus minus 7.3 cm, p < 0.05, girls 167.7 plus minus 4.4 cm to 165.8 plus minus 6.8 cm, p < 0.05). However, a separate comparison of GZG and PEG average values, respectively, among the severity groups showed no significant differences. The results argue for a growth-inhibiting influence from bronchial asthma. The cause has to be severity of illness but direct effects of the atopy on skeletal development is also taken in consideration. Confirmation of these findings requires investigation of a larger group of asthmatics and clarification of the pathophysiological processes in the growing skeletons of atopic children.

摘要

本研究的目的是确定与哮喘儿童生长预后相关的正确数据。为此,对210名年龄在1.7至18.9岁之间的哮喘患儿进行了评估,其中包括153名男性和57名女性。确定了以下参数的数据:实足年龄(CA);骨龄(KA);身高年龄(LA);身高(KH);疾病严重程度;目标成人身高(GZG)和预测成人身高(PEG)。在该组中,发现5.9%的男孩和3.5%的女孩身材矮小(KH < - 2s)。这分别约为正态分布平均值的2.5倍和1.5倍。疾病严重程度最高的儿童,其KH - SDS值的负偏差最大(男孩 - 0.59 ± 1.1,女孩 - 0.97 ± 0.8)。这在女性中具有统计学意义。CA、KA和LA的发育在4岁之前持续正常。从5岁起,在两性中均可观察到KA和LA出现部分显著的生长迟缓。到16岁时,KA值受到的影响更大,之后是LA值。在疾病严重程度组内比较GZG和PEG的平均值发现,无论疾病严重程度如何,两性的PEG值均无一例外地小于GZG。对于男孩症状最严重的组(180.8 ± 6.5 cm至175.8 ± 6.2 cm,p < 0.01)以及两性的整个组(男孩180.2 ± 5.3 cm至178.6 ± 7.3 cm,p < 0.05,女孩167.7 ± 4.4 cm至165.8 ± 6.8 cm,p < 0.05),这两个参数的差异均具有统计学意义。然而,分别在疾病严重程度组中比较GZG和PEG的平均值,未发现显著差异。结果表明支气管哮喘对生长有抑制作用。原因可能是疾病严重程度,但也考虑到特应性对骨骼发育的直接影响。要证实这些发现,需要对更大规模的哮喘患者群体进行研究,并阐明特应性儿童生长骨骼中的病理生理过程。

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