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对受严重急性呼吸综合征(SARS)影响儿童的有氧能力进行长期随访。

Longer term follow up of aerobic capacity in children affected by severe acute respiratory syndrome (SARS).

作者信息

Yu C C W, Li A M, So R C H, McManus A, Ng P C, Chu W, Chan D, Cheng F, Chiu W K, Leung C W, Yau Y S, Mo K W, Wong E M C, Cheung A Y K, Leung T F, Sung R Y T, Fok T F

机构信息

Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.

出版信息

Thorax. 2006 Mar;61(3):240-6. doi: 10.1136/thx.2005.046854. Epub 2006 Jan 31.

Abstract

BACKGROUND

A study was undertaken to investigate the aerobic capacity and pulmonary function of children 6 and 15 months after the diagnosis of severe acute respiratory syndrome (SARS).

METHODS

Thirty four patients of mean age 14.7 years completed both pulmonary function and maximal aerobic capacity tests at 6 months. All had normal clinical examination and were asymptomatic. Their exercise responses were compared with a group of healthy controls. Complete data were collected on 27 of the original 34 cases at 15 months.

RESULTS

Compared with normal controls, the patient group had significantly lower absolute and mass related peak oxygen consumption (peak V o(2) (p<0.01)), higher ventilatory equivalent for oxygen (p<0.01), lower oxygen pulse (p<0.01), and a lower oxygen uptake efficiency slope (p<0.01) at 6 months. This impairment was unexpected and out of proportion with the degree of lung function abnormality. Residual high resolution computed tomography of thorax (HRCT) abnormalities were present in 14 patients. Those with abnormal HRCT findings had significantly lower mass related peak V o(2) than subjects with normal radiology (p<0.01). Absolute and mass related peak V o(2) in the patient group remained impaired at 15 months despite normalisation of lung function in all patients.

CONCLUSIONS

The mechanism for the reduced aerobic capacity in children following SARS is not fully understood, but it is probably a consequence of impaired perfusion to the lungs at peak exercise and deconditioning.

摘要

背景

开展了一项研究,以调查重症急性呼吸综合征(SARS)确诊后6个月和15个月儿童的有氧能力和肺功能。

方法

34名平均年龄14.7岁的患者在6个月时完成了肺功能和最大有氧能力测试。所有患者临床检查均正常且无症状。将他们的运动反应与一组健康对照进行比较。在15个月时,对最初34例中的27例收集了完整数据。

结果

与正常对照组相比,患者组在6个月时的绝对和与体重相关的峰值耗氧量(峰值V o(2) (p<0.01))显著降低,氧通气当量更高(p<0.01),氧脉搏更低(p<0.01),以及氧摄取效率斜率更低(p<0.01)。这种损害出乎意料,且与肺功能异常程度不成比例。14名患者存在胸部高分辨率计算机断层扫描(HRCT)残留异常。HRCT结果异常的患者与放射学正常的受试者相比,与体重相关的峰值V o(2) 显著更低(p<0.01)。尽管所有患者的肺功能已恢复正常,但患者组在15个月时的绝对和与体重相关的峰值V o(2) 仍受损。

结论

SARS后儿童有氧能力降低的机制尚未完全了解,但可能是运动高峰时肺灌注受损和失适应的结果。

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