Malich A, Mainz J, John S, Vogt S, Beyermann H, Mentzel H J, Wünsche K, Zintl F, Kaiser W A
Institut für diagnostische und interventionelle Radiologie, Friedrich-Schiller-Universität, Jena.
Rofo. 2003 Mar;175(3):366-73. doi: 10.1055/s-2003-37832.
To determine broadband ultrasound attenuation (BUA) and speed of sound (SOS) on the os caicis in asthmatic children. To correlate these findings with sex, age, weight and height, topical steroid intake, and asthma severity grade (ASG).
178 children (ASG 1 - 3)/(98 m, 80 f; mean age 11.9 +/- 3.1 y) were consecutively chosen from 4/00 to 9/01. Children with any other chronic disease were excluded. BUA and SOS were measured using SAHARA (Hologic lnc. Waltham, USA). Regional normative BUA and SOS data of 3 299 children (obtained with the same system), were used to calculate age-, weight- and height-matched standard-deviation-scores (SDS) for both sexes. Asthma severity grade and steroidal intake were determined. The highest topical steroid dosage was 500 micro g Fluticasone or 800 micro g Budesonide per day.
10/178 children were small and 7/178 tall per age (5.6 %/3.9 %), 11/178 children were light (6.2 %) and 9 heavy per age (5.0 %). 19 and 45 children had reduced BUA and SOS values, respectively. The following rates of reduced values were observed: girls: BUA 15.0 % (12/80), SOS 25.0 % (20/80); boys: BUA 7.1 %, SOS 25.5 % (7/98 and 25/98). Sexual differences were not significant. Reduced SOS-values were associated with higher severity and occurred significantly more frequent at children under steroidal intake (0.09 vs. 0.25 [BUA] and - 0.37 vs. - 0.07 [SOS]).
Following our results an increase incidence of reduced speed of sound occurs in asthmatic children which is attributed to asthma severity and seems to be negatively influenced even by topically applied low dose steroids. This could be attributed to a steroid induced collagen synthesis deficiency followed by a reduced bone elasticity. Further studies, especially using a longitudinal study design are required to verify these findings.
测定哮喘儿童跟骨的宽带超声衰减（BUA）和声速（SOS）。将这些结果与性别、年龄、体重、身高、局部类固醇摄入量及哮喘严重程度分级（ASG）进行相关性分析。
从2000年4月至2001年9月连续选取178例儿童（ASG 1 - 3级）（98例男性，80例女性；平均年龄11.9±3.1岁）。排除患有其他任何慢性病的儿童。使用SAHARA（美国沃尔瑟姆市Hologic公司）测量BUA和SOS。采用3299例儿童（使用相同系统获得）的区域正常BUA和SOS数据，计算男女年龄、体重和身高匹配的标准差分数（SDS）。确定哮喘严重程度分级和类固醇摄入量。局部类固醇的最高剂量为每日500μg氟替卡松或800μg布地奈德。
按年龄计算，178例儿童中有10例身材矮小（5.6%），7例身材高大（3.9%），178例儿童中有11例体重轻（6.2%），9例体重重（5.0%）。分别有19例和45例儿童的BUA和SOS值降低。观察到以下降低值的发生率：女孩：BUA为15.0%（12/80），SOS为25.0%（20/80）；男孩：BUA为7.1%，SOS为25.5%（7/98和25/98）。性别差异不显著。SOS值降低与更高的严重程度相关，且在服用类固醇的儿童中显著更频繁出现（0.09对0.25 [BUA]以及 - 0.37对 - 0.07 [SOS]）。
根据我们的结果，哮喘儿童中声速降低的发生率增加，这归因于哮喘严重程度，并且似乎即使是局部应用低剂量类固醇也会对其产生负面影响。这可能归因于类固醇诱导的胶原蛋白合成不足，进而导致骨弹性降低。需要进一步研究，尤其是采用纵向研究设计来验证这些发现。
