Qi Yuan-Yuan, Jiang Gao-Li, Wang Li-Bo, Wan Cheng-Zhou, Zhang Xiao-Bo, Qian Li-Ling
Department of Respiration, Children's Hospital of Fudan University, Shanghai 201102, China.
Chin Med J (Engl). 2017;130(1):4-10. doi: 10.4103/0366-6999.196577.
Wheezing is common in early childhood and remains an important health concern. The aim of this study was to assess the lung function of wheezing infants and to investigate the relationship between lung function and respiratory outcome.
Infants <2 years of age with acute lower respiratory tract infection (ALRTI) who had undergone lung function tests were included in the study. They were assigned to wheeze or no wheeze group based on physical examination. Infants without any respiratory diseases were enrolled as controls. Lung function was measured during the acute phase and 3 months after ALRTI. One-year follow-up for infants with ALRTI was achieved.
A total of 252 infants with ALRTI who had acceptable data regarding tidal breathing were included in the final analysis. Compared with the control and the no wheeze groups, infants in the wheeze group had significantly decreased time to peak tidal expiratory flow as a percentage of total expiratory time (TPTEF/TE) (20.1 ± 6.4% vs. 34.4 ± 6.2% and 26.4 ± 8.3%, respectively, P < 0.0001) and significantly increased peak tidal expiratory flow (PTEF) (90.7 ± 26.3 ml/s vs. 79.3 ± 18.4 ml/s and 86.1 ± 28.0 ml/s, respectively, P < 0.01), sReff and Reff. The infants in the wheeze group still had lower TPTEF/TE and volume to peak tidal expiratory flow as a percentage of total expiratory volume (VPTEF/VE) than the no wheeze infants 3 months after the ALRTI. Moreover, there was a significant inverse relationship between TPTEF/TE, VPTEF/VE, and the recurrence of wheezing and pneumonia.
Impaired lung function was present in wheezing infants with ALRTI and the deficits persisted. In addition, the lower level of TPTEF/TE and VPTEF/VE was a risk factor for poor respiratory outcome.
喘息在幼儿期很常见，仍然是一个重要的健康问题。本研究的目的是评估喘息婴儿的肺功能，并研究肺功能与呼吸结局之间的关系。
纳入2岁以下患有急性下呼吸道感染（ALRTI）且接受过肺功能测试的婴儿。根据体格检查将他们分为喘息组或非喘息组。将没有任何呼吸道疾病的婴儿作为对照组。在急性期和ALRTI后3个月测量肺功能。对患有ALRTI的婴儿进行了为期一年的随访。
共有252例患有ALRTI且有可接受的潮气呼吸数据的婴儿纳入最终分析。与对照组和非喘息组相比，喘息组婴儿的呼气潮流量峰值时间占总呼气时间的百分比（TPTEF/TE）显著降低（分别为20.1±6.4%、34.4±6.2%和26.4±8.3%，P<0.0001），呼气潮流量峰值（PTEF）显著增加（分别为90.7±26.3ml/s、79.3±18.4ml/s和86.1±28.0ml/s，P<0.01），sReff和Reff也显著增加。喘息组婴儿在ALRTI后3个月时的TPTEF/TE和呼气潮流量峰值容积占总呼气容积的百分比（VPTEF/VE）仍低于非喘息婴儿。此外，TPTEF/TE、VPTEF/VE与喘息和肺炎的复发之间存在显著的负相关关系。
患有ALRTI的喘息婴儿存在肺功能受损，且这种损害持续存在。此外，TPTEF/TE和VPTEF/VE水平较低是呼吸结局不良的危险因素。
