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降低新生儿肺功能和 5 岁前喘息性疾病的发生。

Reduced neonatal lung function and wheezing illnesses during the first 5 years of life.

机构信息

Dept of Paediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands.

出版信息

Eur Respir J. 2013 Jul;42(1):107-15. doi: 10.1183/09031936.00214711. Epub 2012 Nov 8.

Abstract

Studies of reduced neonatal lung function and wheezing illnesses during childhood show conflicting results. The aim of our study was to assess the association between resistance (Rrs) and compliance (Crs) of the respiratory system by using the single occlusion technique (SOT) and prospectively collected wheezing illnesses during the first 5 years of life in a large birth cohort. SOT was performed during natural sleep before the age of 2 months. Information about wheezing illnesses was collected from the electronic patient file. 549 infants had a successful SOT measurement and complete medical records. Every kPa·L(-1)·s(-1) increase in Rrs was associated with 10% more consultations in the first 3 years of life. Every 10 mL·kPa(-1) increase in Crs was associated with a 14% reduction in consultations in the first 3 years of life, 27% in the fourth to fifth years of life, and a lower probability of having asthma at the age of 5 years (OR 0.66). Children with late-onset or persistent wheezing had significant lower Crs values than their peers. An increased neonatal resistance is associated with more wheezing illnesses during infancy, while a reduced neonatal compliance is associated with more wheezing illnesses during the first 5 years of life, a late-onset or persistent wheezing phenotype, and asthma.

摘要

研究表明,新生儿肺部功能降低与儿童时期的喘息性疾病之间存在关联,但结果相互矛盾。我们的研究旨在通过使用单次阻断技术(SOT)评估呼吸系统阻力(Rrs)和顺应性(Crs)与大型出生队列中儿童生命的前 5 年期间喘息性疾病之间的关系。SOT 在 2 个月大之前的自然睡眠期间进行。喘息性疾病的信息从电子病历中收集。共有 549 名婴儿成功进行了 SOT 测量和完整的医疗记录。Rrs 每增加 1 kPa·L(-1)·s(-1),前 3 年的就诊次数就会增加 10%。Crs 每增加 10 mL·kPa(-1),前 3 年的就诊次数就会减少 14%,第 4 至第 5 年就诊次数减少 27%,5 岁时哮喘的概率也会降低(OR 0.66)。晚发型或持续性喘息的儿童的 Crs 值明显低于同龄人。新生儿阻力增加与婴儿期喘息性疾病增多有关,而新生儿顺应性降低与生命的前 5 年喘息性疾病增多、晚发型或持续性喘息表型以及哮喘有关。

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