Dept of Biostatistics, University of Washington, Children's Hospital Research Institute, Seattle, WA 98195-7232, USA.
Eur Respir J. 2013 Jan;41(1):60-6. doi: 10.1183/09031936.00021612. Epub 2012 May 31.
This study aimed to describe lung function in a cohort of children with cystic fibrosis (CF) who underwent infant pulmonary function tests (IPFTs) and preschool spirometry. Children performed up to four IPFTs (raised volume rapid thoracic compression technique) over 1 yr and five preschool spirometry tests over up to 2 yrs during participation in prospective, multicentre studies of infant and preschool lung function. All lung function data were reviewed centrally for measurement acceptability. 45 children had 252 acceptable measurements (137 IPFTs and 115 preschool spirometries) at ages 0.3-6.5 yrs. The median number of measurements per participant was 6 (range 3-9). Recent Pseudomonas aeruginosa infection was associated with 5.1% (95% CI 0.01-9.9%) lower forced expiratory volume in 0.5 s (FEV(0.5)) and 16.4% (95% CI 7.0-24.9%) lower forced expiratory flow at 25-25% of forced vital capacity (FEF(25-75%)), after adjustment for length, test type and centre. Recent cough was associated with 5.7% (95% CI 1.1-10.1%) lower FEV(0.5) and 10.1% (95% CI 0.6-18.7%) lower FEF(25-75%). Even after accounting for infection status, cough, sex, length, test type and centre, there was significant inter-individual variability in lung function (p<0.01 for each of FEV(0.5), FEF(25-75%) and forced vital capacity). Recent P. aeruginosa infection and cough are associated with lower lung function in children with CF. Significant inter-individual variability in lung function remains to be explained.
本研究旨在描述接受婴儿肺功能测试（IPFT）和学龄前肺活量计测试的囊性纤维化（CF）患儿的肺功能。在参与婴儿和学龄前肺功能的前瞻性多中心研究中，儿童在 1 年内进行了多达 4 次 IPFT（抬高容量快速胸压缩技术），并在长达 2 年内进行了多达 5 次学龄前肺活量计测试。所有肺功能数据均经过中心审查，以确保测量的可接受性。在 0.3-6.5 岁时，45 名儿童有 252 次可接受的测量（137 次 IPFT 和 115 次学龄前肺活量计）。每位参与者的平均测量次数为 6 次（范围 3-9 次）。近期铜绿假单胞菌感染与用力呼气量 0.5 秒（FEV0.5）降低 5.1%（95%CI 0.01-9.9%）和用力呼气流量在 25%至 25%用力肺活量之间（FEF25-75%）降低 16.4%（95%CI 7.0-24.9%）相关，校正后长度、测试类型和中心。近期咳嗽与 FEV0.5 降低 5.7%（95%CI 1.1-10.1%）和 FEF25-75%降低 10.1%（95%CI 0.6-18.7%）相关。即使考虑到感染状态、咳嗽、性别、长度、测试类型和中心，肺功能仍存在显著的个体间变异性（FEV0.5、FEF25-75%和用力肺活量的 p 值均<0.01）。近期铜绿假单胞菌感染和咳嗽与 CF 患儿的肺功能降低有关。肺功能的个体间显著变异性仍有待解释。
