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[智利国家囊性纤维化项目儿童体能特征分析]

[Characterization of the physical capacity in children of the Chilean National Program of Cystic Fibrosis].

作者信息

Puppo Homero, Von Oetinger Astrid, Benz Elizabeth, Torres-Castro Rodrigo, Zagolín Mónica, Boza María Lina, Astorga Luis, Bozzo Rodrigo, Jorquera Pablo, Kogan Ricardo, Perillán José

机构信息

Departamento de Kinesiología, Facultad de Medicina, Universidad de Chile, Chile.

Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Chile.

出版信息

Rev Chil Pediatr. 2018 Oct;89(5):638-643. doi: 10.4067/S0370-41062018005000812.

Abstract

INTRODUCTION

Cystic fibrosis (CF) is an inherited, progressive, multisystem disease. Better physical capacity may slow disease progression, thus improving prognosis and survival. The objective of this research was to evaluate the physical capacity of children admitted to the National CF Pro gram of the Metropolitan Region, Chile.

PATIENTS AND METHOD

A multicenter, cross-sectional stu dy design was used. The inclusion criteria were children aged 6 to 12 years enrolled in the National CF Program; Tanner sexual maturity stage I, no respiratory exacerbations in the last 30 days, and no musculoskeletal pathologies. The maximum aerobic capacity was assessed through the peak oxygen uptake (VO2peak) and determined with an incremental protocol in a magnetic cycle ergometer connected to an ergo-spirometer with which, at the same time, respiratory gases, oxygen consumption and carbon dioxide production values every 30 seconds, anaerobic threshold, and maximum workload were analyzed. The values of forced vital capacity (FVC), forced expiratory volume in 1 second (FEVJ, FEVj/FVC ratio, and forced expiratory flows between 25% and 75% of vital capacity were assessed through ergo-spirometry. At the beginning of the ergo-spirometry, arterial oxygen saturation, respiratory rate, heart rate, blood pressure, tidal volume and the per ception of lower extremity fatigue and dyspnea were recorded using the modified Borg scale. The test lasted approximately 10 minutes.

RESULTS

The clinical records of 43 children collected from six health centers were reviewed. Out of these, 29 children met inclusion criteria, and 23 were re cruited. Two children were unable to participate, reducing the final subject group to 21 (13 males, 8 females). The mean age was 8.8 ± 2 years; weight 30.5 ± 10.9 kg; height 1.32 ± 0.11 m; and body mass index 17.1 ± 3.5 (z-score 0.01 ± 1.34). More than half of the children (61%) had normal weight. The obtained VO2peak was 43.7 ± 6.5 ml/min/kg (106.7 ± 19.8% of the predictive values). Only 10% of the children had values lower than those predicted by sex and age. No correlations were found between VO2peak and anthropometric and pulmonary function variables. Conclu sion: Most of the evaluated children (90%) had physical capacity similar to healthy subjects by sex and age.

摘要

引言

囊性纤维化(CF)是一种遗传性、进行性多系统疾病。更好的身体机能可能会减缓疾病进展,从而改善预后和生存率。本研究的目的是评估智利首都大区国家CF项目收治儿童的身体机能。

患者与方法

采用多中心横断面研究设计。纳入标准为参加国家CF项目的6至12岁儿童;坦纳性成熟I期,过去30天内无呼吸道加重情况,无肌肉骨骼疾病。通过峰值摄氧量(VO2peak)评估最大有氧能力,并在与呼吸气体分析仪相连的磁控自行车测力计上采用递增方案进行测定,同时每30秒分析呼吸气体、耗氧量和二氧化碳产生值、无氧阈值及最大工作量。通过呼吸气体分析仪评估用力肺活量(FVC)、第1秒用力呼气量(FEV1)、FEV1/FVC比值以及肺活量25%至75%之间的用力呼气流量。在呼吸气体分析开始时,使用改良的博格量表记录动脉血氧饱和度、呼吸频率、心率、血压、潮气量以及下肢疲劳和呼吸困难的感知情况。测试持续约10分钟。

结果

回顾了从六个健康中心收集的43名儿童的临床记录。其中,29名儿童符合纳入标准,23名被招募。两名儿童无法参与,最终受试组减至21名(13名男性,8名女性)。平均年龄为8.8±2岁;体重30.5±10.9千克;身高1.32±0.11米;体重指数17.1±3.5(z评分0.01±1.34)。超过一半的儿童(61%)体重正常。测得的VO2peak为43.7±6.5毫升/分钟/千克(为预测值的106.7±19.8%)。只有10%的儿童的值低于按性别和年龄预测的值。未发现VO2peak与人体测量学和肺功能变量之间存在相关性。结论:大多数接受评估的儿童(90%)按性别和年龄的身体机能与健康受试者相似。

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