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镰状细胞贫血患儿的肺气体交换

Lung gas transfer in children with sickle cell anaemia.

作者信息

Sylvester Karl P, Patey Richard A, Kassim Zainab, Rafferty Gerrard F, Rees David, Thein Swee Lay, Greenough Anne

机构信息

King's College London, MRC-Asthma Centre, Division of Asthma, Allergy and Lung Biology, King's College Hospital, Denmark Hill, London SE5 9RS, UK.

出版信息

Respir Physiol Neurobiol. 2007 Aug 15;158(1):70-4. doi: 10.1016/j.resp.2007.04.002. Epub 2007 Apr 8.

Abstract

The impact of sickle cell anaemia (SCA) on respiratory function of children must be determined if their management is to be optimised. Pulmonary diffusing capacity (DL(CO)), corrected for haemoglobin (DL(COc)), therefore was assessed in 24 children with SCA and 24 ethnic matched controls, mean age 11 (range 7-16) years. To determine if any differences found correlated with other measures of lung function, spirometry was undertaken and lung volumes assessed. The SCA children compared to the controls had lower weight (p=0.01), body mass index (p=0.002), DL(CO) (p<0.0001), K(CO) (p=0.003), V(CSB) (p=0.01), FEV(1) (p<0.0001) and FVC (p<0.0001), but greater K(COc) (p=0.001). K(COc) results correlated significantly with PEF (r=-0.58, p=0.02), but not TLC(pleth) (p=0.36), FEV(1) (0.39) or FVC (p=0.36). In conclusion, when corrected for haemoglobin levels, the SCA children compared to controls of similar age had elevated gas transfer per unit lung volume results. Our results suggest this abnormality is independent of other lung function abnormalities.

摘要

若要优化镰状细胞贫血(SCA)患儿的治疗,就必须确定其对呼吸功能的影响。因此,对24名SCA患儿和24名种族匹配的对照儿童进行了评估,这些儿童的平均年龄为11岁(范围7 - 16岁),评估指标为校正血红蛋白后的肺弥散量(DL(CO)),即DL(COc)。为了确定所发现的任何差异是否与其他肺功能指标相关,进行了肺活量测定并评估了肺容积。与对照组相比,SCA患儿的体重更低(p = 0.01)、体重指数更低(p = 0.002)、DL(CO)更低(p < 0.0001)、K(CO)更低(p = 0.003)、V(CSB)更低(p = 0.01)、第一秒用力呼气容积(FEV(1))更低(p < 0.0001)和用力肺活量(FVC)更低(p < 0.0001),但K(COc)更高(p = 0.001)。K(COc)结果与呼气峰值流速(PEF)显著相关(r = -0.58,p = 0.02),但与体容积描记法测得的肺总量(TLC(pleth))无关(p = 0.36)、与FEV(1)无关(p = 0.39)或与FVC无关(p = 0.36)。总之,校正血红蛋白水平后,与年龄相仿的对照组相比,SCA患儿每单位肺容积的气体交换结果升高。我们的结果表明,这种异常与其他肺功能异常无关。

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