Nystad W, Samuelsen S O, Nafstad P, Edvardsen E, Stensrud T, Jaakkola J J K
Department of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Thorax. 2002 Dec;57(12):1021-7. doi: 10.1136/thorax.57.12.1021.
There have been difficulties in applying spirometric tests to children of preschool age.
The feasibility of measuring lung function was examined in 652 children aged 3-6 years using dynamic spirometry with an animation programme and the guidelines approved by the European Respiratory Society.
Data from 603 (92%) children with at least two acceptable forced expiratory manoeuvres were analysed; 408 (68%) achieved at least three acceptable manoeuvres. Children with only two acceptable manoeuvres were younger, shorter, and weighed less (p<0.001). The lower levels of lung function in this group were partly explained by body size. 63% of those with three acceptable manoeuvres had a difference of </=5% between the highest and second highest forced expiratory volume in 1 second (FEV(1)); when a difference of </=10% was applied, 91% of the children were included. A similar trend was seen for forced vital capacity (FVC). The acceptability and reproducibility increased with increasing age, and levels of lung function increased linearly with age. The linear regression model showed that standing height was a satisfactory predictor of lung function; the explained fraction of variance (R(2)) was 59% for FEV(1). Most FVC manoeuvres in children older than 3 years were acceptable and reproducible.
Spirometric testing is feasible in preschool children and may be useful for both clinical practice and research. This study may fill the deficiency in reference values for European preschool children.
将肺量计测试应用于学龄前儿童存在困难。
使用带有动画程序的动态肺量计以及欧洲呼吸学会批准的指南，对652名3至6岁儿童的肺功能测量可行性进行了检查。
分析了603名（92%）至少有两次可接受的用力呼气动作的儿童的数据；408名（68%）实现了至少三次可接受的动作。只有两次可接受动作的儿童年龄更小、身高更矮、体重更轻（p<0.001）。该组较低的肺功能水平部分由体型解释。在有三次可接受动作的儿童中，63%的人一秒用力呼气量（FEV(1)）的最高值与第二高值之间的差异≤5%；当应用≤10%的差异时，91%的儿童被纳入。用力肺活量（FVC）也有类似趋势。可接受性和重复性随年龄增长而增加，肺功能水平随年龄呈线性增加。线性回归模型显示，站立身高是肺功能的一个满意预测指标；FEV(1)的方差解释比例（R(2)）为59%。3岁以上儿童的大多数FVC动作是可接受且可重复的。
肺量计测试在学龄前儿童中是可行的，可能对临床实践和研究都有用。本研究可能填补欧洲学龄前儿童参考值的不足。
