Pediatric Department.
Tropical Medicine Department.
J Pediatr Gastroenterol Nutr. 2018 Sep;67(3):346-350. doi: 10.1097/MPG.0000000000001989.
The aim of the study was to evaluate the frequency and type of pulmonary dysfunction in newly diagnosed children with inflammatory bowel disease (IBD) and the correlation between pulmonary function tests (PFTs) and IBD activity.
It is an observational case-control study. One hundred newly diagnosed children with IBD were enrolled as the patient group, which was further subdivided into 52 with Crohn disease (CD) and 48 with ulcerative colitis (UC). Fifty healthy children matched for age, sex, height, and body mass index (BMI) served as the control group. PFTs in the form of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, residual volume (RV), total lung capacity (TLC), mid-forced expiratory flow of 25% to 75% (FEF 25%-75%) and diffusing capacity of the lung for carbon monoxide (DLCO) were evaluated in all studied children. PFTs were measured at diagnosis, every 6 months for a period of 3 years, during remission and at least once during activity in patient group.
There was significant progressive deterioration in all PFTs in IBD patients compared with their PFTs at the start of the study (P < 0.05) except for FEV1/FVC, RV, and TLC (P > 0.05). There was significant deterioration during disease activity compared with remission state as regards FEV1, FVC, FEF 25% to 75%, and DLCO (P < 0.05). Significant negative correlation was found between disease activity in both UC and CD groups and FEV1, FVC, FEF 25% to 75%, and DLCO.
Subclinical PFTs abnormalities are common in pediatric IBD even during remission period. So, periodic PFTs evaluation should be considered in the routine follow-up of IBD children.
本研究旨在评估新诊断为炎症性肠病(IBD)的儿童的肺部功能障碍的频率和类型,以及肺功能检查(PFTs)与 IBD 活动之间的相关性。
这是一项观察性病例对照研究。共纳入 100 例新诊断为 IBD 的儿童作为患者组,其中克罗恩病(CD)52 例,溃疡性结肠炎(UC)48 例。选择 50 名年龄、性别、身高和体重指数(BMI)相匹配的健康儿童作为对照组。对所有研究儿童进行第 1 秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC、残气量(RV)、肺总量(TLC)、25%至 75%用力呼气中期流量(FEF 25%-75%)和一氧化碳弥散量(DLCO)等形式的 PFTs 评估。在患者组中,在诊断时、每 6 个月进行一次,为期 3 年,在缓解期间和活动期间至少进行一次 PFTs 测量。
与研究开始时相比,IBD 患者的所有 PFTs 均有显著的进行性恶化(P<0.05),除了 FEV1/FVC、RV 和 TLC(P>0.05)。与缓解状态相比,疾病活动期间 FEV1、FVC、FEF 25%至 75%和 DLCO 均显著恶化(P<0.05)。UC 和 CD 组的疾病活动与 FEV1、FVC、FEF 25%至 75%和 DLCO 均呈显著负相关。
即使在缓解期,儿科 IBD 也常见亚临床 PFTs 异常。因此,应在 IBD 儿童的常规随访中考虑定期进行 PFTs 评估。