Balinotti Juan E, Chang Daniel V, Lubovich Silvina, Rodríguez Viviana, Zaragoza Silvina, Escobar Natalia, Kofman Carlos, Pérez Gabriela L, Ardiles Victoria, Teper Alejandro
Centro Respiratorio "Dr. Alberto R. Álvarez", Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires.
Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina.
Arch Argent Pediatr. 2019 Oct 1;117(5):323-329. doi: 10.5546/aap.2019.eng.323.
The early prevention of respiratory complications in children with cystic fibrosis is determining for a longer survival. The implementation of lung function tests in the first months of life allows to detect respiratory involvement, even in asymptomatic children.
To assess the course of lung function in children with cystic fibrosis in their first 3 years of life and identify the factors affecting it.
Observational, retrospective, analytical study. Children younger than 36 months with at least 2 lung function tests were included.
Between 2008 and 2016, 48 patients were included; 85 % of them had been diagnosed by newborn screening. The first lung function test was done at 5 months old. The median Z-score of maximal flow at functional residual capacity was -0.05 (interquartile range: -1.09 to 1.08). The median change in the maximal flow Z-score between tests was -0.32 (interquartile range: -1.11 to 0.25), p = 0.045. Patients with Staphylococcus aureus respiratory infections, especially methicillin-resistant SA, evidenced a greater deterioration of lung function compared to those without infection. Neither sex nor the type of genetic mutation were associated with the course of lung function. Nutritional recovery throughout the study was really good.
Lung function in children with cystic fibrosis worsens progressively during their first 3 years of life. These findings are associated with Staphylococcus aureus respiratory infections.
早期预防囊性纤维化患儿的呼吸道并发症对延长生存期至关重要。在生命的最初几个月进行肺功能测试有助于检测呼吸道受累情况,即使是无症状的儿童。
评估囊性纤维化患儿出生后前3年的肺功能进程,并确定影响其的因素。
观察性、回顾性、分析性研究。纳入年龄小于36个月且至少进行过2次肺功能测试的儿童。
2008年至2016年,共纳入48例患者;其中85%通过新生儿筛查确诊。首次肺功能测试在5个月时进行。功能残气量时最大流速的Z评分中位数为-0.05(四分位间距:-1.09至1.08)。两次测试之间最大流速Z评分的中位数变化为-0.32(四分位间距:-1.11至0.25),p = 0.045。与未感染的患者相比,金黄色葡萄球菌呼吸道感染患者,尤其是耐甲氧西林金黄色葡萄球菌感染患者,肺功能恶化更为明显。性别和基因突变类型均与肺功能进程无关。整个研究期间营养恢复情况良好。
囊性纤维化患儿在出生后的前3年肺功能逐渐恶化。这些发现与金黄色葡萄球菌呼吸道感染有关。