Section of Pediatric Pulmonology, Allergy, and Sleep Medicine, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Section of Pediatric Hematology and Oncology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Pediatr Pulmonol. 2021 May;56(5):1165-1172. doi: 10.1002/ppul.25186. Epub 2020 Dec 14.
The lung clearance index (LCI) derived from the multiple breath washout test (MBW), is both feasible and sensitive to early lung disease detection in young children with cystic fibrosis and asthma. The utility of LCI has not been studied in children with sickle cell disease (SCD). We hypothesized that children with SCD, with or without asthma or airway hyperreactivity (AHR), would have an elevated LCI compared to healthy controls.
Children with SCD from a single center between the ages of 6 and 18 years were studied at baseline health and completed MBW, spirometry, plethysmography and blood was drawn for serum markers. Results were compared to healthy controls of similar race, age, and gender.
Healthy controls (n = 35) had a significantly higher daytime oxygen saturation level, weight and body mass index but not height compared to participants with SCD (n = 34). Total lung capacity (TLC) z-scores were significantly higher in the healthy controls compared to those with SCD (0.87 [1.13] vs. 0.02 [1.27]; p = .005) while differences in forced expiratory volume in 1 s z-scores approached significance (0.26 [0.97] vs. -0.22 [1.09]; p = .055). There was no significant difference in LCI between the healthy controls compared to participants with SCD (7.29 [0.72] vs. 7.40 [0.69]; p = .514).
LCI did not differentiate SCD from healthy controls in children between the ages of 6 and 18 years at baseline health. TLC may be an important pulmonary function measure to follow longitudinally in the pediatric SCD population.
从多次呼吸冲洗试验（MBW）得出的肺清除指数（LCI）在检测囊性纤维化和哮喘的幼儿早期肺疾病方面既可行又敏感。尚未在镰状细胞病（SCD）患儿中研究 LCI 的实用性。我们假设，患有 SCD 且患有或不患有哮喘或气道高反应性（AHR）的儿童的 LCI 会比健康对照组高。
在基线健康时，对来自单一中心的 6 至 18 岁的 SCD 儿童进行研究，并完成 MBW、肺活量测定法、体积描记法，以及为血清标志物抽血。将结果与具有相似种族、年龄和性别的健康对照组进行比较。
健康对照组（n=35）的日间血氧饱和度水平、体重和体重指数明显高于 SCD 参与者（n=34），但身高无差异。与 SCD 参与者相比，健康对照组的总肺容量（TLC）z 分数明显更高（0.87 [1.13] 与 0.02 [1.27]；p=0.005），而 1 秒用力呼气量 z 分数的差异接近显著（0.26 [0.97] 与 -0.22 [1.09]；p=0.055）。健康对照组与 SCD 参与者之间的 LCI 无显着差异（7.29 [0.72] 与 7.40 [0.69]；p=0.514）。
在基线健康的 6 至 18 岁儿童中，LCI 并未将 SCD 与健康对照组区分开来。TLC 可能是小儿 SCD 人群中需要进行纵向随访的重要肺功能测量指标。
