Patterson Joän M, Wall Melanie, Berge Jerica, Milla Carlos
Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, MN 55454, USA.
Pediatr Pulmonol. 2009 Jan;44(1):46-53. doi: 10.1002/ppul.20925.
The purpose of this study was to examine the relationship of strains, resources, feelings, and behaviors about treatment adherence reported by youth with cystic fibrosis (CF) with repeated clinic measures of their pulmonary function and nutritional status.
Linear mixed models, stratified by gender, adjusting for age, were used to examine the effects of strains, resources, and adherence behaviors on repeated pulmonary function and nutritional status measures. All 10-21 years old with CF at the Minnesota Cystic Fibrosis Center were invited by mail to participate. Of these 177 youth, 51% (43 boys, 47 girls) returned surveys. Forced expiratory volume in 1 sec and predicted weight-for-height were extracted from participants' clinic records for the 18 months following receipt of the survey.
Females showed significantly greater variability in repeated measures of pulmonary function and nutritional status compared to males. Parent-youth strains, physical strains, activity limitations, and cough suppression had significant effects on the 18-month mean of pulmonary function measures for females, but only physical strains had a significant effect for males.
Compared to males, females experienced more strains and poorer treatment adherence, which may be factors associated with declines in pulmonary function observed among females with CF during the adolescent years.
本研究旨在探讨囊性纤维化（CF）青年患者报告的与治疗依从性相关的压力、资源、感受和行为，与他们肺功能和营养状况的重复临床测量值之间的关系。
采用按性别分层、调整年龄的线性混合模型，来检验压力、资源和依从行为对重复肺功能和营养状况测量值的影响。明尼苏达囊性纤维化中心邀请了所有10至21岁的CF患者通过邮件参与研究。在这177名青年中，51%（43名男孩，47名女孩）回复了调查问卷。从参与者收到调查问卷后的18个月临床记录中提取一秒用力呼气量和预测身高体重。
与男性相比，女性在肺功能和营养状况的重复测量中表现出显著更大的变异性。亲子压力、身体压力、活动受限和咳嗽抑制对女性肺功能测量的18个月平均值有显著影响，但对男性只有身体压力有显著影响。
与男性相比，女性经历了更多压力和更差的治疗依从性，这可能是与CF女性青少年期间观察到的肺功能下降相关的因素。
