Tampere Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland.
Seinäjoki Central Hospital, Seinäjoki, Finland.
Pediatr Pulmonol. 2018 May;53(5):552-558. doi: 10.1002/ppul.23977. Epub 2018 Feb 27.
The transition from early childhood wheezing to persistent asthma is linked to lung function impairment over time. Little is known how the methods used to study lung function at different ages correlate longitudinally.
Sixty-four children with a history of hospitalization for bronchiolitis before 6 months of age were prospectively studied with impulse oscillometry (IOS) at the mean age of 6.3 years and these preschool IOS results were compared with flow-volume spirometry (FVS) measurements at mean age of 11.4 years.
The baseline respiratory system resistance at 5 Hz (Rrs5) showed a modest statistically significant correlation with all baseline FVS parameters except FVC. The post-bronchodilator (post-BD) Rrs5 showed a modest statistically significant correlation with post-BD FEV and FEV /FVC. The bronchodilator-induced decrease in Rrs5 showed a modest statistically significant correlation with the percent increase in FEV . Baseline and post-BD respiratory reactance at 5 Hz (Xrs5) showed a modest statistically significant correlation with baseline and post-BD FVS parameters except post-BD FEV /FVC, respectively, and post-BD Xrs5 showed a strong correlation with post-BD FVC (ρ = 0.61) and post-BD FEV (ρ = 0.59). In adjusted linear regression, preschool Xrs5 remained as a statistically significant independent predictor of FVS parameters in adolescence; the one-unit decrease in the Z-score of preschool post-BD Xrs5 predicted 9.6% lower post-BD FEV , 9.3% lower post-BD FVC, and 9.7% lower post-BD MEF when expressed as %-predicted parameters.
Persistent post-BD small airway impairment in children with a history of bronchiolitis detected with IOS at preschool age predicted FVS results measured in early adolescence.
从幼儿喘息到持续性哮喘的转变与肺功能随时间的损害有关。目前尚不清楚用于研究不同年龄段肺功能的方法如何进行纵向相关。
64 名患有 6 个月前毛细支气管炎住院史的儿童前瞻性地接受了脉冲振荡法（IOS）检测，平均年龄为 6.3 岁，这些学龄前 IOS 结果与平均年龄为 11.4 岁的流量-容积呼吸描记法（FVS）测量结果进行了比较。
5Hz 基础呼吸系统阻力（Rrs5）与除 FVC 外的所有 FVS 基础参数均呈中度显著统计学相关。支气管扩张剂后 Rrs5 与支气管扩张剂后 FEV 和 FEV/FVC 呈中度显著统计学相关。Rrs5 下降的支气管扩张剂诱导程度与 FEV 的百分比增加呈中度显著统计学相关。5Hz 基础和支气管扩张剂后呼吸电抗（Xrs5）与基础和支气管扩张剂后 FVS 参数呈中度显著统计学相关，除了支气管扩张剂后 FEV/FVC 外，支气管扩张剂后 Xrs5 与支气管扩张剂后 FVC（ρ=0.61）和支气管扩张剂后 FEV（ρ=0.59）呈强相关。在调整后的线性回归中，学龄前 Xrs5 仍然是青少年 FVS 参数的统计学显著独立预测因子；学龄前支气管扩张剂后 Xrs5 的 Z 分数每降低一个单位，预测支气管扩张剂后 FEV 降低 9.6%，FVC 降低 9.3%，MEF 降低 9.7%，以预测参数的百分比表示。
患有毛细支气管炎病史的儿童在学龄前通过 IOS 检测到的持续支气管扩张剂后小气道损害，可预测青少年早期 FVS 结果。
