Soares Ana Alice de Almeida, Barros Camila Moraes, Santos Cássia Giulliane Costa, Dos Santos Maria Renata Aragão, Silva José Rodrigo Santos, Silva Junior Walderi Monteiro da, Simões Silvia de Magalhães
a University Hospital, Federal University of Sergipe , Aracaju , Sergipe , Brazil.
J Asthma. 2018 Mar;55(3):259-265. doi: 10.1080/02770903.2017.1326133. Epub 2017 May 26.
Rhinitis and asthma decrease quality of life. Few studies have assessed the performance of children with asthma or rhinitis under submaximal exercise. We evaluated maximal respiratory pressures, spirometric parameters, and ability to sustain submaximal exercise in these children before and after the 6-minute walk test (6MWT), compared to healthy children.
This cross-sectional, analytical study included 89 children aged 6-12 years in outpatient follow-up: 27 healthy (H), 31 with rhinitis (R), and 31 with mild asthma under control (A). Pulmonary function parameters and maximal respiratory pressures were measured before and 5, 10, and 30 minutes after the 6MWT. Wilcoxon test was used to compare numerical numerical variables between two groups and analysis of variance or Kruskal-Wallis test for comparison among three groups.
Total distance traveled in the 6MWT was similar among the three groups. Compared to pre-test values, VEF1 (Forced Expiratory Volume in 1 second), VEF0.75 (Forced Expiratory Volume in 0.75 second), and FEF25-75 (Forced Expiratory Flow 25-75% of the Forced Vital Capacity - CVF - curve) decreased significantly after the 6MWT in group A, and VEF0.75, FEF25-75, and VEF1/CVF decreased significantly in group R. Groups A and R had lower Maximum Inspiratory Pressure values than group H before and after the 6MWT at all time points assessed.
The findings suggest that children with rhinitis and mild asthma present with alterations in respiratory muscle strength and pulmonary function not associated with clinical complaints, reinforcing the concept of the united airways.
鼻炎和哮喘会降低生活质量。很少有研究评估哮喘或鼻炎患儿在次最大运动量运动下的表现。我们将这些患儿在6分钟步行试验(6MWT)前后的最大呼吸压力、肺量计参数以及维持次最大运动量运动的能力与健康儿童进行了比较。
这项横断面分析研究纳入了89名6至12岁门诊随访儿童:27名健康儿童(H组)、31名鼻炎患儿(R组)和31名病情得到控制的轻度哮喘患儿(A组)。在6MWT前以及6MWT后5分钟、10分钟和30分钟测量肺功能参数和最大呼吸压力。采用Wilcoxon检验比较两组间的数值变量,采用方差分析或Kruskal-Wallis检验比较三组间的数值变量。
三组在6MWT中行走的总距离相似。与测试前值相比,A组在6MWT后1秒用力呼气容积(VEF1)、0.75秒用力呼气容积(VEF0.75)和25%-75%用力肺活量(CVF)曲线的用力呼气流量(FEF25-75)显著下降,R组的VEF0.75、FEF25-75和VEF1/CVF显著下降。在所有评估时间点,A组和R组在6MWT前后的最大吸气压力值均低于H组。
研究结果表明,鼻炎和轻度哮喘患儿存在呼吸肌力量和肺功能改变,且与临床症状无关,这进一步强化了气道一体的概念。