Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
Pediatr Pulmonol. 2020 Oct;55(10):2745-2753. doi: 10.1002/ppul.24976. Epub 2020 Aug 4.
Extremely preterm birth is a risk factor for reduced lung function later in life, and clinical follow-up from early childhood is recommended. Dynamic spirometry is the most widely used method to assess airway obstruction, but impulse oscillometry (IOS) may be an alternative method that is easier to perform in young children. The feasibility and agreement between spirometry and IOS outcome variables has not been investigated in children born extremely preterm.
To determine the feasibility of and correlation between spirometry and IOS in pre-school children born extremely preterm.
Spirometry and IOS were performed in 6-year-old children born extremely preterm (n = 88) and age-matched term controls (n = 84) in Stockholm, Sweden. Correlations between spirometry and IOS outcome variables were analyzed using Pearson's partial correlation, adjusting for height.
Success rate for spirometry (60%) was lower than for IOS (93%) but did not differ significantly between the preterm and term groups (56% and 64% for spirometry, P = .25; and 92% and 94% for IOS, P = .61). Correlations between spirometry and IOS outcomes were at best moderate (Spearman's r = -0.31 to -0.56). Normal IOS identified 69% to 90% of those with normal spirometry. A negative predictive value of 90% was found for R5-R20 versus FEV /FVC, suggesting that IOS may be used to exclude obstructive airway disease as measured by spirometry.
IOS is a more feasible method than spirometry to assess lung function in young children irrespective of gestational age at birth and could be considered an alternative in children who cannot perform spirometry.
极早产是日后肺功能降低的一个风险因素，建议对其进行早期儿童期的临床随访。动态肺量测定法是评估气道阻塞最广泛使用的方法，但脉冲震荡（IOS）可能是一种更易于在幼儿中进行的替代方法。在极早产儿中，尚未研究肺量测定法和 IOS 结果变量之间的可行性和一致性。
确定极早产儿学龄前儿童进行肺量测定法和 IOS 的可行性和相关性。
在瑞典斯德哥尔摩，对 88 名极早产儿（n=88）和年龄匹配的足月对照（n=84）进行了肺量测定法和 IOS 检查。使用 Pearson 偏相关分析，对身高进行调整，分析肺量测定法和 IOS 结果变量之间的相关性。
肺量测定法（60%）的成功率低于 IOS（93%），但在早产儿和足月儿组之间没有显著差异（肺量测定法分别为 56%和 64%，P=0.25；IOS 分别为 92%和 94%，P=0.61）。肺量测定法和 IOS 结果之间的相关性最多为中度（Spearman r=-0.31 至-0.56）。IOS 正常可识别 69%至 90%的肺量测定法正常者。R5-R20 与 FEV/FVC 的阴性预测值为 90%，提示 IOS 可用于排除肺量测定法所测的气道阻塞性疾病。
IOS 是一种比肺量测定法更可行的方法，可用于评估无论出生时的胎龄如何的幼儿的肺功能，对于无法进行肺量测定法的儿童，可考虑作为替代方法。
