Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Vaccine and Infectious Disease Research Center, Translational Health Science and Technology Institute, Faridabad, Haryana, India.
BMJ Open Respir Res. 2020 Feb;7(1). doi: 10.1136/bmjresp-2019-000436.
Acute respiratory infections (ARIs) in infancy may have a long-term impact on the developing respiratory system. We planned a prospective cohort study to determine the impact of ARI during infancy on the pulmonary function test indices at 3 years of age.
A cohort of normal, full-term newborns were followed up 6 monthly and during ARI episodes. Infant pulmonary function tests (IPFTs) were performed at baseline and each follow-up visit using tidal breathing flow-volume loop, rapid thoracoabdominal compression (RTC) and raised volume RTC manoeuvres. During each ARI episode, nasopharyngeal aspirates were tested for respiratory pathogens by real-time PCR.
We screened 3421 neonates; 310 were enrolled; IPFT was performed in 225 (boys: 125 (55.6%)) at 3 years. During infancy, 470 ARI episodes were documented in 173 infants. At 3 years, children with history of any ARI episode during infancy had lower forced expiratory volume in 1 s (FEV), forced expiratory volume in 0.75 s (FEV), forced expiratory volume in 0.5 s (FEV), forced expiratory flow between 25% and 75% of FVC (FEF), and maximal expiratory flow at 25% of FVC (MEF) as compared with those without any ARI episode during infancy. The ratio of tidal expiratory flow (TEF) at 25% or 50% of tidal expiratory volume to peak TEF (TEF or TEF/peak TEF) at 3 years was significantly increased in children who had ARI in infancy.
ARI during infancy is associated with impaired pulmonary function indices such as increased resistance and decreased forced expiratory flow and volume at 3 years of age.
婴儿期急性呼吸道感染（ARI）可能对发育中的呼吸系统产生长期影响。我们计划进行一项前瞻性队列研究，以确定婴儿期 ARI 对 3 岁时肺功能测试指标的影响。
我们对正常、足月的新生儿进行了队列研究，并在 6 个月时和 ARI 发作期间进行了随访。在基线和每次随访时使用潮气呼吸流量-容积环、快速胸廓-腹部压缩（RTC）和升高容积 RTC 手法进行婴儿肺功能测试（IPFT）。在每次 ARI 发作期间，通过实时 PCR 检测鼻咽抽吸物中的呼吸道病原体。
我们筛查了 3421 名新生儿；310 名被纳入；225 名（男孩 125 名，占 55.6%）在 3 岁时进行了 IPFT。在婴儿期，173 名婴儿中有 470 次 ARI 发作。在 3 岁时，有任何婴儿期 ARI 发作史的儿童的 1 秒用力呼气量（FEV）、0.75 秒用力呼气量（FEV）、0.5 秒用力呼气量（FEV）、用力呼气量在 25%和 75%肺活量之间的流速（FEF）和肺活量的 25%最大呼气流量（MEF）均低于无婴儿期任何 ARI 发作史的儿童。与无婴儿期 ARI 发作史的儿童相比，在婴儿期患有 ARI 的儿童在 3 岁时，潮气流速（TEF）在潮气流速的 25%或 50%与峰 TEF（TEF 或 TEF/峰 TEF）的比值明显增加。
婴儿期 ARI 与 3 岁时肺功能指标受损有关，如阻力增加和用力呼气流量和容积降低。
