对患有和未患有慢性肺病的早产学龄前儿童进行肺功能测量。

Lung function measurement in prematurely born preschool children with and without chronic lung disease.

作者信息

Kairamkonda V R, Richardson J, Subhedar N, Bridge P D, Shaw N J

机构信息

Department of Neonatal Intensive Care, Leicester Royal Infirmary, Leicester, UK.

出版信息

J Perinatol. 2008 Mar;28(3):199-204. doi: 10.1038/sj.jp.7211911. Epub 2008 Jan 10.

DOI:10.1038/sj.jp.7211911

PMID:18185519

Abstract

OBJECTIVE

Prematurely born infants often have recurrent wheeze and long-term respiratory morbidity at follow-up. Assessment of airways obstruction in preschool children is feasible using the interrupter resistance (Rint) but has rarely been examined in preterm children with and without chronic lung disease (CLD). The objective of this study was to determine lung function measured by the interrupter technique, its feasibility in the ambulatory setting and respiratory health in prematurely born preschool children with and without CLD.

STUDY DESIGN

Preterm children of 2 to 4 years with severe CLD (>30% oxygen at 36 weeks and discharged home receiving supplemental oxygen) (n=43, median gestational age 27 weeks and median birth weight 995 g) and without CLD (n=33, median gestational age 29 weeks and median birth weight 1366 g) attempting lung function test for the first time were enrolled. Respiratory symptoms score was calculated using a questionnaire. A single set of 10 consecutive Rint measurements was obtained using a portable device (MicroRint). Median of at least five occlusions with consistent shape of mouth pressure-time curves was taken to be a Rint measurement. To assess feasibility the children were categorized as 'satisfactory', 'failure' and 'rejected' depending on the outcome of the test. Outcome variables were respiratory symptoms score and Rint.

RESULT

Satisfactory Rint measurement was obtained in 46 (61%) children, 9 (36%) 2-year olds, 17 (65%) 3-year olds and 20 (80%) 4-year olds. As compared with the preterm control children (n=18), CLD children (n=28) had significantly higher respiratory symptoms score (18.5 vs 6, P<0.01) and Rint expressed as absolute values (kPa l(-1)) and z-scores (1.33 vs 1.16 and 1.42 vs 1.0, P<0.01), respectively.

CONCLUSION

Rint measurement is feasible in prematurely born children of preschool age in the ambulatory setup. Preschool children with severe CLD may be identified from preterm children without CLD by increased Rint that may be used as a screening tool and as an outcome measure for interventions.

摘要

目的

早产婴儿在随访时常常出现反复喘息和长期呼吸系统疾病。使用阻断器阻力（Rint）评估学龄前儿童的气道阻塞是可行的，但在患有和未患有慢性肺病（CLD）的早产儿童中很少进行检查。本研究的目的是确定通过阻断器技术测量的肺功能、其在门诊环境中的可行性以及患有和未患有CLD的早产学龄前儿童的呼吸健康状况。

研究设计

纳入首次尝试进行肺功能测试的2至4岁患有重度CLD（36周时需氧量>30%且出院回家仍接受补充氧气）的早产儿童（n = 43，中位胎龄27周，中位出生体重995克）和未患有CLD的早产儿童（n = 33，中位胎龄29周，中位出生体重1366克）。使用问卷计算呼吸症状评分。使用便携式设备（MicroRint）获得一组连续10次的Rint测量值。将至少五次口压 - 时间曲线形状一致的阻断测量值的中位数作为Rint测量值。为评估可行性，根据测试结果将儿童分为“满意”、“失败”和“拒绝”三类。结果变量为呼吸症状评分和Rint。

结果

46名（61%）儿童获得了满意的Rint测量值，其中9名（36%）2岁儿童、17名（65%）3岁儿童和20名（80%）4岁儿童。与早产对照儿童（n = 18）相比，CLD儿童（n = 28）的呼吸症状评分显著更高（18.5对6，P<0.01），Rint以绝对值（kPa l(-1)）和z评分表示时也显著更高（分别为1.33对1.16和1.42对1.0，P<0.01）。