Child Health, University of Aberdeen, Aberdeen, UK.
Department of Paediatric Respiratory Medicine and Allergology, University Medical Centre Rotterdam, Erasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.
Pediatr Allergy Immunol. 2021 Aug;32(6):1208-1216. doi: 10.1111/pai.13503. Epub 2021 Mar 29.
There are limited data describing lung function changes in children after an asthma exacerbation. Our hypothesis was that lung function does not fully recover in children in the months following an asthma exacerbation.
We used a data set of children with asthma where lung function (including FEV , FEV /FVC ratio and FEF ) was measured at 3-month intervals over a year. Mixed-level models compared spirometry measured on two occasions 3 months apart before a single exacerbation (assessments 1 and 2) with measurements made on two occasions after the exacerbation (assessments 3 and 4), with adjustment for covariates. Changes in spirometry over a year were also analysed across those with exacerbations in no, one or more than one 3-month periods.
For the 113 children who had a single exacerbation, spirometry measured at assessments 1 or 2 did not differ from measurements at assessments 3 or 4 when the whole population was considered. When stratified into tertiles by change in %FEV between assessments 2 and 3, those with the greater reduction were more likely to be treated with long-acting beta-agonist, but in this category, %FEV at assessment 4 had returned to the value at assessment 1. %FEV did not change over a 12-month period within and between the three exacerbation categories (n = 809).
One or more asthma exacerbation was not associated with a fall in lung function for the whole population. In a subset of individuals, lung function does fall after an exacerbation but returns to pre-exacerbation values after a period of months.
目前仅有少量数据描述哮喘发作后儿童的肺功能变化。我们的假设是，在哮喘发作后的几个月内，儿童的肺功能并未完全恢复。
我们使用了一组患有哮喘的儿童的数据，这些儿童在一年内每隔 3 个月进行一次肺功能（包括 FEV 、FEV/FVC 比值和 FEF ）测量。混合水平模型比较了在单次哮喘加重前两次相隔 3 个月的两次（评估 1 和 2）的肺活量测量值与加重后两次（评估 3 和 4）的测量值，并对协变量进行了调整。还分析了在没有、一个或多个 3 个月期间发生加重的儿童中，在一年中肺活量测量值的变化。
对于 113 名仅有单次哮喘加重的儿童，当考虑整个人群时，评估 1 或 2 时的肺活量测量值与评估 3 或 4 时的测量值没有差异。当按评估 2 和 3 之间 FEV 变化的百分比进行三分位分层时，FEV 减少较多的儿童更有可能接受长效β激动剂治疗，但在该组中，评估 4 时的 FEV 已恢复到评估 1 时的水平。在三个加重类别（n=809）内和之间，12 个月内 FEV 没有变化。
一次或多次哮喘加重与整个人群的肺功能下降无关。在一部分人群中，肺功能确实在哮喘加重后下降，但在几个月后会恢复到加重前的水平。
