Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Pediatr Pulmonol. 2014 Jan;49(1):84-90. doi: 10.1002/ppul.22760. Epub 2013 Feb 8.
Pulmonary disease contributes to significant morbidity and mortality in people with ataxia telangiectasia (A-T). To determine the association between age and lung function in children and young adults with A-T and to identify factors associated with decreased lung function, pulmonary function tests were performed in 100 consecutive people with A-T.
Children and adults ranging from 6 to 29 years of age and with the diagnosis of A-T were recruited, and underwent pulmonary function tests.
The mean forced vital capacity % predicted (FVC %) in the population was 56.6 ± 20.0. Males and females between 6 and 10 years of age had similar pulmonary function. Older females were found to have significantly lower FVCs % than both older males (P < 0.02) and younger females (P < 0.001). The use of supplemental gamma globulin was associated with significantly lower FVC %. A modest correlation was found between higher radiation-induced chromosomal breakage and lower FVC % in males. No significant change in FVC % was found in a subset of subjects (n = 25) who underwent pulmonary function testing on two or more occasions over an average of 2 years.
In children and young adults with A-T, older females and people who required supplemental gamma globulin had significantly lower lung function by cross-sectional analysis. Stable lung function is possible over a 2-year period. Recognition of groups who are at higher risk for lower pulmonary function may help direct care and improve clinical outcomes in people with A-T.
肺疾病会导致共济失调毛细血管扩张症(A-T)患者出现显著的发病率和死亡率。为了确定 A-T 患者的年龄与肺功能之间的关系,并确定与肺功能下降相关的因素,对 100 例连续的 A-T 患者进行了肺功能测试。
招募了年龄在 6 至 29 岁之间、诊断为 A-T 的儿童和成人,并进行了肺功能测试。
该人群的平均用力肺活量预测值(FVC%)为 56.6±20.0。6 至 10 岁的男性和女性肺功能相似。年龄较大的女性的 FVC%明显低于年龄较大的男性(P<0.02)和年龄较小的女性(P<0.001)。使用补充丙种球蛋白与 FVC%显著降低相关。在男性中,较高的辐射诱导染色体断裂与较低的 FVC%之间存在适度的相关性。在平均 2 年的时间内进行了两次或两次以上肺功能测试的一组亚组(n=25)中,FVC%没有明显变化。
在 A-T 的儿童和年轻成人中,横断面分析显示,年龄较大的女性和需要补充丙种球蛋白的患者肺功能明显较低。在 2 年内,肺功能可能保持稳定。认识到肺功能较低的高风险人群可能有助于指导 A-T 患者的护理和改善临床结局。