Fuger Marilyn, Aupiais Camille, Thouvenin Guillaume, Taytard Jessica, Tamalet Aline, Escudier Estelle, Boizeau Priscilla, Corvol Harriet, Beydon Nicole
AP-HP, Unité d'Exploration Fonctionnelle Respiratoire, Hôpital Armand-Trousseau, Paris, France.
AP-HP, Unité d'Epidémiologie Clinique, Hôpital Robert Debré, Paris, France; Université Paris Diderot, Sorbonne Paris-Cité, INSERM U1123 et CIC-EC 1426, Paris, France; INSERM U1138, Equipe 22, Sciences de l'information au service de la médecine personnalisée, Paris, France.
Respir Physiol Neurobiol. 2018 May;251:1-7. doi: 10.1016/j.resp.2018.01.010. Epub 2018 Jan 31.
Primary ciliary dyskinesia (PCD) and cystic fibrosis (CF) both entail bronchiectasis and pulmonary impairment as measured using spirometry, during childhood. We aimed at looking whether blood gas exchanges progressed differently between CF and PCD children in a retrospective study of repeated measurements. Comparisons between groups (Wilcoxon-Mann-Whitney and Chi-squared tests) and a mixed linear model, adjusted for age, evaluated associations between diseases and PaO, PaCO or PaOPaCO ratio. Among 42 PCD and 73 CF children, 62% and 59% had respectively bronchiectasis (P = 0.75). Spirometry and blood gases were similar at inclusion (PaO median [IQR] PCD -1.80 [-3.40; -0.40]; CF -1.80 [-4.20; 0.60] z-scores; P = 0.72). PaO and PaO-PaCO ratio similarly and significantly decreased with age in both groups (P < 0.01) whereas PaCO increased more in CF (P = 0.02) remaining within the range of normal (except for one child). To conclude, gas exchange characteristics, similarly initially impaired in PCD and CF children, tended to less deteriorate with time in PCD children who could benefit from an early diagnosis.
原发性纤毛运动障碍(PCD)和囊性纤维化(CF)在儿童期均会导致支气管扩张和肺功能损害,这可通过肺量计测量得出。在一项重复测量的回顾性研究中,我们旨在探究CF和PCD儿童的血气交换进展是否存在差异。通过组间比较(Wilcoxon-Mann-Whitney检验和卡方检验)以及针对年龄进行调整的混合线性模型,评估疾病与动脉血氧分压(PaO)、动脉血二氧化碳分压(PaCO)或PaO/PaCO比值之间的关联。在42名PCD儿童和73名CF儿童中,分别有62%和59%患有支气管扩张(P = 0.75)。纳入研究时,肺量计测量结果和血气指标相似(PCD组动脉血氧分压中位数[四分位间距]为-1.80[-3.40;-0.40];CF组为-1.80[-4.20;0.60]z评分;P = 0.72)。两组中,动脉血氧分压和PaO/PaCO比值均随年龄增长而显著下降(P < 0.01),而CF组动脉血二氧化碳分压升高更为明显(P = 0.02),但仍在正常范围内(除一名儿童外)。总之,PCD和CF儿童的气体交换特征最初同样受损,但PCD儿童的情况随时间推移恶化程度较小,他们可能得益于早期诊断。