Gaffin Jonathan M, Shotola Nancy Lichtenberg, Martin Thomas R, Phipatanakul Wanda
Division of Respiratory Diseases, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, U.S.A.
J Asthma. 2010 Sep;47(7):762-7. doi: 10.3109/02770903.2010.485664.
In 2007 the American Thoracic Society (ATS) recommended guidelines for acceptability and repeatability for assessing spirometry in preschool children. The authors aim to determine the feasibility of spirometry among children in this age group performing spirometry for the first time in a busy clinical practice.
First-time spirometry for children age 4 to 5 years old was selected from the Children's Hospital Boston Pulmonary Function Test (PFT) database. Maneuvers were deemed acceptable if ( 1 ) the flow-volume loop showed rapid rise and smooth descent; ( 2 ) the back extrapolated volume (V(be)), the volume leaked by a subject prior to the forced maneuver, was ≤ 80 ml and 12.5% of forced vital capacity (FVC); and ( 3 ) cessation of expiratory flow was at a point ≤ 10% of peak expiratory flow rate (PEFR). Repeatability was determined by another acceptable maneuver with forced expiratory volume in t seconds (FEV(t)) and FVC within 10% or 0.1 L of the best acceptable maneuver. Post hoc analysis compared spirometry values for those with asthma and cystic fibrosis to normative values.
Two hundred and forty-eight preschool children performed spirometry for the first time between August 26, 2006, and August 25, 2008. At least one technically acceptable maneuver was found in 82.3% (n = 204) of the tests performed. Overall, 54% of children were able to perform acceptable and repeatable spirometry based on the ATS criteria. Children with asthma or cystic fibrosis did not have spirometry values that differed significantly from healthy controls. However, up to 29% of the overall cohort displayed at least one abnormal spirometry value.
Many preschool-aged children are able to perform technically acceptable and repeatable spirometry under normal conditions in a busy clinical setting. Spirometry may be a useful screen for abnormal lung function in this age group.
2007年，美国胸科学会（ATS）推荐了评估学龄前儿童肺功能测定可接受性和可重复性的指南。作者旨在确定在繁忙的临床实践中，该年龄组儿童首次进行肺功能测定的可行性。
从波士顿儿童医院肺功能测试（PFT）数据库中选取4至5岁儿童的首次肺功能测定数据。如果满足以下条件，则动作被视为可接受：（1）流速-容量环显示快速上升和平滑下降；（2）反向推算容积（V(be)），即受试者在用力动作之前泄漏的容积，≤80 ml且占用力肺活量（FVC）的12.5%；（3）呼气流量停止点≤呼气峰值流速（PEFR）的10%。可重复性通过另一次可接受的动作来确定，其中t秒用力呼气量（FEV(t)）和FVC在最佳可接受动作的10%或0.1 L范围内。事后分析将哮喘和囊性纤维化患儿的肺功能测定值与正常值进行比较。
2006年8月26日至2008年8月25日期间，248名学龄前儿童首次进行了肺功能测定。在82.3%（n = 204）的测试中发现了至少一次技术上可接受的动作。总体而言，根据ATS标准，54%的儿童能够进行可接受且可重复的肺功能测定。哮喘或囊性纤维化患儿的肺功能测定值与健康对照组无显著差异。然而，整个队列中高达29%的儿童至少有一项肺功能测定值异常。
许多学龄前儿童在繁忙的临床环境中，在正常条件下能够进行技术上可接受且可重复的肺功能测定。肺功能测定可能是该年龄组肺功能异常的有用筛查方法。
