Hanrahan J P, Tager I B, Castile R G, Segal M R, Weiss S T, Speizer F E
Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Am Rev Respir Dis. 1990 May;141(5 Pt 1):1127-35. doi: 10.1164/ajrccm/141.5_Pt_1.1127.
We conducted 151 tests of pulmonary function (PF) on 72 healthy infants younger than 2 yr of age using partial expiratory flow volume (PEFV) maneuvers and helium dilution determination of FRC. After tests were grouped into four strata based on postconception (PC) age, variability and sex differences in level of PF were examined. No significant sex differences were found for any PF measure in any age stratum, even when somatic size was controlled by length correction. Force expiratory flow measures, however, tended to be greater in girls than in boys in the youngest infants. Flow measures demonstrated greater between-subject variability than did volumes, and variability was greatest in the youngest infants. Within-subject variability also was more pronounced for flow measures, particularly in infants younger than 50 PC wk of age. Across the age range of infants studied, all PF measures were related linearly to somatic size as measured by either length, weight, or chest circumference. Length offered the best individual size correction of the three size parameters studied. Linear regression of PF parameters versus length demonstrated FRC to increase at 5.39 ml/cm over this age range, whereas flow at FRC increased by 9.67 ml/s/cm. We conclude that the variability of infant PF measures is greatest in early infancy, that measures of forced expiratory flow are more variable than volume measures, and that sex differences in infant PF do not appear significant. Length is related linearly to PF measures and offers reasonable size correction for healthy infants younger than 18 months of age.
我们对72名2岁以下的健康婴儿进行了151次肺功能(PF)测试,采用部分呼气流量容积(PEFV)操作和氦稀释法测定功能残气量(FRC)。根据孕龄(PC)将测试分为四个层次后,研究了PF水平的变异性和性别差异。在任何年龄层次中,任何PF指标均未发现显著的性别差异,即使通过身长校正来控制身体大小也是如此。然而,在最年幼的婴儿中,用力呼气流量指标在女孩中往往高于男孩。流量指标的受试者间变异性大于容积指标,且在最年幼的婴儿中变异性最大。流量指标的受试者内变异性也更明显,尤其是在孕龄小于50周的婴儿中。在研究的婴儿年龄范围内,所有PF指标均与通过身长、体重或胸围测量的身体大小呈线性相关。在所研究的三个大小参数中,身长对个体大小的校正效果最佳。PF参数与身长的线性回归显示,在此年龄范围内,FRC以每厘米5.39毫升的速度增加,而FRC时的流量以每秒每厘米9.67毫升的速度增加。我们得出结论,婴儿PF指标的变异性在婴儿早期最大,用力呼气流量指标比容积指标更具变异性,且婴儿PF的性别差异似乎不显著。身长与PF指标呈线性相关,可为18个月以下的健康婴儿提供合理的大小校正。