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3岁以下喘息性小儿肺炎患者的肺功能测试

Pulmonary Function Testing in Pediatric Pneumonia Patients With Wheezing Younger Than 3 Years of Age.

作者信息

Chen Jichang, Liu Xin, Du Wei, Srivastava Ruma, Fu Jinjian, Zheng Min, Zhou Jin, McGrath Eric

机构信息

Liuzhou Maternity and Child Healthcare Hospital, Liuzhou, China.

Children's Hospital of Michigan, Detroit, MI, USA.

出版信息

Glob Pediatr Health. 2019 Apr 9;6:2333794X19840357. doi: 10.1177/2333794X19840357. eCollection 2019.

Abstract

Wheezing symptoms are one of the risk factors in young pneumonia patients that often leads to asthma development. Infant pulmonary function test (iPFT) is potentially a useful tool to help identify and manage these high-risk pneumonia patients. To examine whether patients with wheezing symptoms are more likely to have poorer pulmonary function and treatment outcomes, and also to explore the clinical benefit of iPFT in young pneumonia patients, we conducted a retrospective analysis of 1005 pneumonia inpatients <3 years of age who had undergone iPFT testing in 2016 at Liuzhou Maternity and Child Healthcare Hospital in Guang-Xi, China. . We identified from the hospital database 505 pneumonia patients who presented with wheezing and 500 without wheezing. Univariate analysis showed that wheezing symptoms, viral infection, age <1 year, female gender, and prematurity were significantly associated with poorer iPFT results. After adjusting for confounders, patients with wheezing showed significantly poorer pulmonary function. Patients with wheezing had longer length of stay (7.9 ± 3.9 days vs 6.5 ± 2.6 days; < .001) and lower percent with no residual clinical symptoms at discharge (58% vs 98%; < .001) when compared with those of non-wheezing patients. In addition, 81% of patients with viral infection as compared with 43% of patients with nonviral infection presented with wheezing symptoms ( < .001). Wheezing symptoms were associated with poorer iPFT measures and treatment outcomes for pneumonia inpatients <3 years of age. Patients with wheezing had poorer treatment outcomes. iPFT can be useful in assessing and monitoring young patients with high risk of developing asthma or chronic lung disease later in life.

摘要

喘息症状是年轻肺炎患者发生哮喘的危险因素之一。婴幼儿肺功能测试(iPFT)可能是帮助识别和管理这些高危肺炎患者的有用工具。为了研究有喘息症状的患者是否更有可能肺功能较差且治疗效果不佳,并探讨iPFT在年轻肺炎患者中的临床益处,我们对2016年在中国广西柳州市妇幼保健院接受iPFT检测的1005例3岁以下肺炎住院患者进行了回顾性分析。我们从医院数据库中确定了505例有喘息症状的肺炎患者和500例无喘息症状的患者。单因素分析显示,喘息症状、病毒感染、年龄<1岁、女性和早产与较差的iPFT结果显著相关。在对混杂因素进行校正后,有喘息症状的患者肺功能明显较差。与无喘息症状的患者相比,有喘息症状的患者住院时间更长(7.9±3.9天对6.5±2.6天;P<.001),出院时无残留临床症状的比例更低(58%对98%;P<.001)。此外,81%的病毒感染患者出现喘息症状,而非病毒感染患者的这一比例为43%(P<.001)。喘息症状与3岁以下肺炎住院患者较差的iPFT指标和治疗效果相关。有喘息症状的患者治疗效果较差。iPFT有助于评估和监测日后有发生哮喘或慢性肺病高风险的年轻患者。

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