Mellies Uwe, Stehling Florian, Dohna-Schwake Christian
Departement of Pediatric Pulmonolgy and Sleep Medicine, University of Essen, Children's Hospital, Hufelandstr. 55, 45122 Essen, Germany.
Physiol Meas. 2014 Oct;35(10):1975-81. doi: 10.1088/0967-3334/35/10/1975. Epub 2014 Sep 17.
Assessment of inspiratory muscle function (IMF) is limited in children with neuromuscular disorders, because respiratory muscle tests are poorly standardized and valid normative data are unavailable. We investigated maximum inspiratory pressure after exhalation to residual volume (MIP), mouth occlusion pressure (P0.1) and time of inspiration during quiet breathing and derived inspiratory muscle load (P0.1/MIP), and tension time index (TTI) in 301 healthy schoolchildren 6-16 years old. Gender-specific and age-dependent percentile curves for MIP were drawn with the median, 5%, 10%, 25%, 75% and 95% percentile. P0.1 was equal in boys and girls (0.23 ± 0.11 kPa), while MIP was significantly higher in boys (6.8 ± 2.2 versus 5.8 ± 2.4 kPa). Consequently, P0.1/MIP (4.8% ± 3.2% versus 4.0% ± 3.1%) and TTI (0.2 ± 0.14 versus 0.16 ± 0.14) were significantly higher in girls. MIP was 2.90 + 0.36 × age (kPa) and 3.19 + 0.24 × age (kPa) in boys and girls, respectively. The 95% confidence intervals for boys and girls, respectively, were MIP, 6.3-7.3 kPA and 5.4-6.2 kPa; P0.1/MIP, 3.5%-4.5% and 4.3%-5.3%; TTI, 0.14-0.18 and 0.18-0.22; and P0.1, 0.20-0.24 kPa for both. IMF in children has a wide interindividual variability; however percentile curves facilitate a longitudinal assessment of individual patients. Furthermore, narrow confidence intervals allow for comparisons of study populations, making IMF an appropriate endpoint for clinical trials.
在患有神经肌肉疾病的儿童中,吸气肌功能(IMF)的评估受到限制,因为呼吸肌测试的标准化程度较差且缺乏有效的正常参考数据。我们对301名6至16岁的健康学童进行了呼气至残气量后的最大吸气压力(MIP)、口腔阻断压(P0.1)以及安静呼吸时的吸气时间测定,并计算了吸气肌负荷(P0.1/MIP)和张力时间指数(TTI)。绘制了MIP的性别特异性和年龄相关百分位数曲线,包括中位数、第5百分位数、第10百分位数、第25百分位数、第75百分位数和第95百分位数。男孩和女孩的P0.1相等(0.23±0.11kPa),而男孩的MIP显著更高(6.8±2.2与5.8±2.4kPa)。因此,女孩的P0.1/MIP(4.8%±3.2%与4.0%±3.1%)和TTI(0.2±0.14与0.16±0.14)显著更高。男孩和女孩的MIP分别为2.90 + 0.36×年龄(kPa)和3.19 + 0.24×年龄(kPa)。男孩和女孩的MIP的95%置信区间分别为6.3 - 7.3kPa和5.4 - 6.2kPa;P0.1/MIP为3.5% - 4.5%和4.3% - 5.3%;TTI为0.14 - 0.18和0.18 - 0.22;P0.1两者均为0.20 - 0.24kPa。儿童的吸气肌功能存在很大的个体差异;然而,百分位数曲线有助于对个体患者进行纵向评估。此外,狭窄的置信区间便于对研究人群进行比较,使吸气肌功能成为临床试验的合适终点指标。