Kaczmarczyk Katarzyna, Wiszomirska Ida, Szturmowicz Magdalena, Magiera Andrzej, Błażkiewicz Michalina
Head of Physiology Department, Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34 Street, Warsaw, Poland.
Józef Piłsudski University of Physical Education in Warsaw, Faculty of Rehabilitation, Warsaw, Poland.
Ther Adv Respir Dis. 2017 Jul;11(7):277-287. doi: 10.1177/1753465817710595.
To evaluate the long-term impact of preterm birth on respiratory function in female patients born preterm, we undertook spirometric examinations twice, as they reached the age of puberty, then follow-up examinations of part of the same cohort in adulthood. We sought evidence that preterm birth is correlated with poorer spirometric results into adulthood.
A total of 70 girls (aged 12.2 ± 1.5 years in 1997) who had been born preterm (at 34.7 ± 1.86 weeks, none having experienced bronchopulmonary dysplasia) took part in spriometric examinations in 1997 and again in 1998. Of those, after a gap of 17 years, a group of 12 were successfully recontacted and participated in the 2015 examination as adults (then aged 27.6 ± 2.6 years, born at 34.5 ± 1.92 weeks). We compared spirometric results across the adolescent and adult examinations, and compared the adult results with an adult reference group.
The percentage values of FEV (forced expiratory volume in 1 s), FVC (forced vital capacity) and MVV (maximal voluntary ventilation) showed significant improvement between the two examinations in the early adolescent period. In adulthood, FEV%pred (percentage predicted forced expiratory volume in 1 s) showed no statistically significant difference. The mean values of both FVC and FVC%pred (percentage predicted forced vital capacity) for the preterm-born group were lower than for the reference group, but this was not statistically significant. The preterm-born group showed lower values of such parameters as forced expiratory flow at 25-75% of FVC, MEF (maximal expiratory flow at 25% of forced vital capacity) and FEV/FVC as compared with the reference group, but again without statistical significance.
(1) A somewhat below-norm level of respiratory parameters among preterm-born girls entering pubescence may attest to continued negative impact on their respiratory system. (2) A significant improvement in their spirometric results 1 year later may indicate that pubescence helps compensate for the earlier negative effect of preterm birth. (3) No significant differences were seen in lung function in preterm-born adults as compared with a reference group of adults, although the preterm-born group did exhibit lower values of all parameters studied and more frequent obstructive disorders.
为评估早产对早产女性患者呼吸功能的长期影响，我们在她们进入青春期时进行了两次肺活量测定检查，随后对同一队列中的部分患者在成年期进行了随访检查。我们试图寻找证据证明早产与成年期较差的肺活量测定结果相关。
共有70名早产女孩（1997年时年龄为12.2±1.5岁，早产时孕周为34.7±1.86周，均未患支气管肺发育不良）于1997年和1998年参加了肺活量测定检查。其中，在间隔17年后，成功重新联系到一组12人，并让她们作为成年人参加了2015年的检查（当时年龄为27.6±2.6岁，早产时孕周为34.5±1.92周）。我们比较了青春期和成年期检查的肺活量测定结果，并将成年期结果与一个成年参照组进行了比较。
在青春期早期的两次检查之间，第1秒用力呼气容积（FEV）、用力肺活量（FVC）和最大自主通气量（MVV）的百分比值有显著改善。在成年期，预测第1秒用力呼气容积百分比（FEV%pred）无统计学显著差异。早产组的FVC和预测用力肺活量百分比（FVC%pred）的平均值均低于参照组，但无统计学显著性。与参照组相比，早产组在FVC的25%-75%时的用力呼气流量、25%用力肺活量时的最大呼气流量（MEF）以及FEV/FVC等参数值较低，但同样无统计学显著性。
（1）进入青春期的早产女孩呼吸参数略低于正常水平，这可能证明早产对其呼吸系统持续存在负面影响。（2）1年后她们的肺活量测定结果有显著改善，这可能表明青春期有助于弥补早产早期的负面影响。（3）与成年参照组相比，早产成年女性的肺功能无显著差异，尽管早产组所有研究参数值均较低，且阻塞性疾病更常见。
