Pérez Margarita, Groeneveld Iris F, Santana-Sosa Elena, Fiuza-Luces Carmen, Gonzalez-Saiz Laura, Villa-Asensi José R, López-Mojares Luis M, Rubio Margarita, Lucia Alejandro
School of Doctorate Studies and Research, European University of Madrid, Madrid, Spain.
Pediatr Pulmonol. 2014 Jul;49(7):641-9. doi: 10.1002/ppul.22878. Epub 2013 Sep 9.
Children with cystic fibrosis (CF) often have to be hospitalized because of acute exacerbation of their respiratory symptoms. Given the fact that improved peak oxygen uptake (VO2peak ) is positively associated with lung function and overall health in children with CF, this study examined the association between VO2peak and the need for hospitalization in a cohort of pediatric CF patients.
In a 3-year study, 77 CF children with mild-to-moderately severe CF (forced expiratory volume in 1 sec [FEV1 ] ≥ 50%) underwent a maximal exercise test to determine VO2peak . Anthropometric, lung function and muscle strength measurements were also conducted and dates of hospitalization were recorded for the study period. Associations were then determined between the variables recorded and hospitalization by univariate and multivariate Cox proportional hazards regression analyses.
VO2peak was 38.6 ± 6.7 ml kg(-1) min(-1) for boys and 31.9 ± 6.9 ml kg(-1) min(-1) for girls. In multivariate analyses, VO2peak was the only variable significantly associated with time to hospitalization (hazard ratio 0.91, P = 0.03).
A significant association was detected between greater aerobic fitness, and lower risk of hospitalization. Because hospitalization due to respiratory exacerbation is a powerful prognostic factor, our findings provide further support for the importance of aerobic fitness evaluation in the management of children with mild-to-moderately severe CF.
患有囊性纤维化（CF）的儿童常因呼吸道症状急性加重而需住院治疗。鉴于CF患儿峰值摄氧量（VO2peak）的改善与肺功能及整体健康呈正相关，本研究在一组儿科CF患者队列中探讨了VO2peak与住院需求之间的关联。
在一项为期3年的研究中，77例患有轻至中度严重CF（第1秒用力呼气量[FEV1]≥50%）的CF儿童接受了最大运动测试以确定VO2peak。还进行了人体测量、肺功能和肌肉力量测量，并记录了研究期间的住院日期。然后通过单变量和多变量Cox比例风险回归分析确定所记录变量与住院之间的关联。
男孩的VO2peak为38.6±6.7 ml·kg-1·min-1，女孩为31.9±6.9 ml·kg-1·min-1。在多变量分析中，VO2peak是与住院时间显著相关的唯一变量（风险比0.91，P = 0.03）。
检测到较高的有氧适能与较低的住院风险之间存在显著关联。由于因呼吸道加重而住院是一个强有力的预后因素，我们的研究结果为有氧适能评估在轻至中度严重CF患儿管理中的重要性提供了进一步支持。
