Motomura Chikako, Matsuzaki Hiroshi, Odajima Hiroshi, Oki Takeshi, Yasunari Yusuke, Kawano Toshiaki, Iwata Mihoko, Okabe Koki, Wakatsuki Masatoshi, Murakami Yoko, Taba Naohiko, Honjo Satoshi, Ohga Shouichi
Department of Pediatrics, National Hospital Organization Fukuoka National Hospital, Fukuoka, Japan.
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Asthma. 2022 Feb;59(2):297-305. doi: 10.1080/02770903.2020.1853767. Epub 2020 Dec 7.
The relationship between exercise-induced bronchoconstriction (EIB) and exertional dyspnea in children and adolescents is yet to be fully established. This study examined whether indicators of fractional exhaled nitric oxide (FeNO), forced expiratory volume in 1 s (FEV) percent predicted at baseline, and dyspnea are useful for predicting children and adolescents with EIB.
We enrolled 184 children and adolescents diagnosed with asthma (mean age 11.2 years); participants were divided into two groups according to age (12 years) and were subjected to a 6-min exercise challenge test. Lung function tests and modified Borg scale scores were used to examine perceptions of dyspnea at 0, 5 and 15 min after exercise.
Among children, the maximum percentage drop in FEV after exercise correlated significantly with FeNO (adjusted β = 2.3, < 0.001) and with the perception of dyspnea at 5 min after exercise (adjusted β = 1.9, < 0.001). Among adolescents, the maximum percentage drop in FEV correlated with FeNO (adjusted β = 2.7, = 0.007) and with lung function (FEV, percent predicted; adjusted β = -0.28, = 0.006). Children with EIB had significantly stronger dyspnea after exercise than did children without EIB. Adolescents even without EIB may experience more exertional dyspnea than children without EIB.
Overall, our findings indicated that EIB was associated with FeNO and exertional dyspnea in asthmatic children. By contrast, EIB was associated with FEV percent predicted at baseline and FeNO but not with exertional dyspnea in asthmatic adolescents.
运动诱发支气管收缩（EIB）与儿童及青少年运动性呼吸困难之间的关系尚未完全明确。本研究旨在探讨呼出一氧化氮分数（FeNO）、基线时1秒用力呼气容积（FEV）预计值百分比及呼吸困难指标是否有助于预测EIB患儿及青少年。
我们纳入了184例诊断为哮喘的儿童及青少年（平均年龄11.2岁）；参与者按年龄（12岁）分为两组，并进行6分钟运动激发试验。在运动后0、5和15分钟，使用肺功能测试和改良的博格量表评分来评估呼吸困难感受。
在儿童中，运动后FEV的最大下降百分比与FeNO显著相关（调整后β = 2.3，P < 0.001），且与运动后5分钟的呼吸困难感受相关（调整后β = 1.9，P < 0.001）。在青少年中，运动后FEV的最大下降百分比与FeNO相关（调整后β = 2.7，P = 0.007），并与肺功能（FEV预计值百分比）相关（调整后β = -0.28，P = 0.006）。EIB患儿运动后的呼吸困难明显比无EIB的患儿更严重。即使没有EIB的青少年，其运动性呼吸困难可能也比无EIB的儿童更多。
总体而言，我们的研究结果表明，EIB与哮喘儿童的FeNO及运动性呼吸困难相关。相比之下，EIB与哮喘青少年的基线FEV预计值百分比及FeNO相关，但与运动性呼吸困难无关。
