Princess Amalia Children's Clinic, Isala Klinieken, Zwolle, The Netherlands.
Eur Respir J. 2013 May;41(5):1068-73. doi: 10.1183/09031936.00130212. Epub 2012 Sep 27.
Hyperventilation and other clinical manifestations of dysfunctional breathing have been reported in childhood, but the prevalence is unknown. In adults, dysfunctional breathing may be a relevant comorbidity in asthma. We aimed to determine the prevalence of dysfunctional breathing in children with asthma and its impact on asthma control. We performed a cross-sectional survey in 203 asthmatic children (aged 5-18 years), using the Nijmegen Questionnaire and the paediatric Asthma Control Questionnaire. Dysfunctional breathing was found in 11 (5.3%) children; more females (eight (12.9%) out of 62) than males (three (2.1%) out 144, p=0.002). There was a dose-dependent relationship between increasing Nijmegen Questionnaire scores (increased risk of dysfunctional breathing) and poorer asthma control. Poor asthma control was more common in patients with dysfunctional breathing (10 (90.9%) out of 11 children) than in children without (65 (32.3%) out of 192 children; OR 19.3, 95% CI 3.14-430.70; p<0.0001). The median Asthma Control Questionnaire in children with dysfunctional breathing was higher (median (range) 2.00 (1.50-3.17)) than in children without (0.50 (0.17-1.17); p<0.001). The prevalence of dysfunctional breathing in children and adolescents referred to a hospital-based paediatric asthma clinic for severe or difficult-to-control asthma is 5%. The association between dysfunctional breathing and asthma control suggests that this may be a clinically relevant comorbidity in paediatric asthma.
过度通气和其他呼吸功能障碍的临床表现已在儿童中报道，但流行情况尚不清楚。在成年人中，呼吸功能障碍可能是哮喘的一个相关合并症。我们旨在确定哮喘儿童呼吸功能障碍的患病率及其对哮喘控制的影响。我们对 203 名哮喘儿童（5-18 岁）进行了横断面调查，使用了奈梅亨问卷和儿科哮喘控制问卷。在 11 名（5.3%）儿童中发现了呼吸功能障碍；女性（62 名中的 8 名（12.9%））多于男性（144 名中的 3 名（2.1%），p=0.002）。随着奈梅亨问卷评分的增加（呼吸功能障碍的风险增加），与哮喘控制较差呈剂量依赖性关系。呼吸功能障碍患儿的哮喘控制较差更为常见（11 名儿童中的 10 名（90.9%）），而无呼吸功能障碍患儿中哮喘控制较差的情况较少（192 名儿童中的 65 名（32.3%）；比值比 19.3，95%置信区间 3.14-430.70；p<0.0001）。呼吸功能障碍儿童的哮喘控制问卷中位数较高（中位数（范围）2.00（1.50-3.17）），而无呼吸功能障碍儿童的哮喘控制问卷中位数较低（0.50（0.17-1.17）；p<0.001）。在因严重或难以控制的哮喘而被转至医院儿科哮喘诊所的儿童和青少年中，呼吸功能障碍的患病率为 5%。呼吸功能障碍与哮喘控制之间的关联表明，这可能是儿科哮喘的一个具有临床意义的合并症。
