Pediatric Pulmonary Service, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatr Pulmonol. 2020 Jul;55(7):1671-1680. doi: 10.1002/ppul.24773. Epub 2020 Apr 16.
Compartment analysis (CA) based on nitrogen multiple-breath washout (N MBW) has been shown to allow the assessment of specific volume and ventilation of faster- and slower-ventilating lung compartments of the lung in adults with cystic fibrosis (CF). The aim of this study was to extend previous findings into the pediatric age range.
Cross-sectional multicenter observational study in children with CF and healthy controls (HC) was done with the assessment of N MBW and spirometry. A two-lung compartment model-based analysis (CA) was used to estimate size and function of faster- and slower-ventilating lung compartments from N MBW.
A total of 125 children with CF and 177 HC, median age 10.8 (range, 2.8-18.9) years, were included in the analysis. CA could be calculated in 66 (53%) children with CF compared with 48 (27%) HC (P < .0001). The proportion of the slower-ventilating lung compartment was significantly smaller in children with CF (53.5%; 95% confidence interval [CI]: 51.9%-55.7%) compared with HC (62.2%; 95% CI: 59.0%-65.0%) The regional specific ventilation of the slower compartment (rV ,slow/rFRC,slow, %) was significantly lower in children with CF (4.9%; 95% CI: 4.5-5.9) compared with HC (9.7%, 95% CI: 9.2-10.9), and showed inverse correlation to lung clearance index (r = -.65; P < .0001), S × VT (r = -.36; P = .003) and S × VT (r = -.51; P < .0001). There was no significant difference in pulmonary parameters between children with CF with and without feasible CA.
CA is less feasible in children than in adults and correlated to other MBW parameters. The clinical value of CA is still unclear and is yet to be established.
基于氮多次呼吸清除（N MBW）的隔室分析（CA）已被证明可用于评估囊性纤维化（CF）成人中更快和更慢通气肺隔室的特定体积和通气。本研究的目的是将以前的发现扩展到儿科年龄范围。
在患有 CF 和健康对照（HC）的儿童中进行了一项横断面多中心观察性研究，并进行了 N MBW 和肺活量测定。使用两肺隔室模型分析（CA）从 N MBW 估计更快和更慢通气肺隔室的大小和功能。
共纳入 125 名 CF 患儿和 177 名 HC，中位年龄为 10.8 岁（范围，2.8-18.9 岁）。在 CF 患儿中，66 名（53%）可以计算 CA，而 HC 中 48 名（27%）可以计算 CA（P <.0001）。CF 患儿的较慢通气肺隔室比例明显小于 HC（53.5%；95%置信区间[CI]：51.9%-55.7%）。CF 患儿较慢隔室的区域性特定通气（rV ，slow/rFRC，slow，%）明显低于 HC（4.9%；95% CI：4.5-5.9），与肺清除指数（r = -0.65；P <.0001）、S × VT（r = -0.36；P = .003）和 S × VT（r = -0.51；P <.0001）呈负相关。有和没有可行 CA 的 CF 患儿的肺参数之间无显著差异。
CA 在儿童中比在成人中更不可行，并且与其他 MBW 参数相关。CA 的临床价值尚不清楚，有待进一步确定。
