应用振荡法测量唐氏综合征患儿的肺功能。
Airwave oscillometry to measure lung function in children with Down syndrome.
机构信息
Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, University of Colorado, Aurora, CO, USA.
出版信息
Pediatr Res. 2022 Jun;91(7):1775-1780. doi: 10.1038/s41390-021-01664-7. Epub 2021 Jul 29.
BACKGROUND
Children with Down syndrome are at risk for significant pulmonary co-morbidities, including recurrent respiratory infections, dysphagia, obstructive sleep apnea, and pulmonary vascular disease. Because the gold standard metric of lung function, spirometry, may not be feasible in children with intellectual disabilities, we sought to assess the feasibility of both airwave oscillometry and spirometry in children with Down syndrome.
METHODS
Thirty-four children with Down syndrome aged 5-17 years were recruited. Participants performed airwave oscillometry and spirometry before and 10 min after albuterol. Outcomes include success rates, airway resistance and reactance pre- and post-bronchodilator, and bronchodilator response.
RESULTS
Participants were median age 9.2 years (interquartile range 7.2, 12.0) and 47% male. Airwave oscillometry was successful in 26 participants (76.5%) and 4 (11.8%) were successful with spirometry. No abnormalities in airway resistance were detected, and 16/26 (61.5%) had decreased reactance. A positive bronchodilator response by oscillometry was observed in 5/23 (21.7%) of those with successful pre- and post-bronchodilator testing.
CONCLUSIONS
Measures of pulmonary function were successfully obtained using airwave oscillometry in children with Down syndrome, which supports its use in this high-risk population.
IMPACT
Children with Down syndrome are at risk for significant pulmonary co-morbidities, but the gold standard metric of lung function, spirometry, may not be feasible in children with intellectual disabilities. This may limit the population's enrollment in clinical trials and in standardized clinical care. In this prospective study of lung function in children with Down syndrome, airwave oscillometry was successful in 76% of participants but spirometry was successful in only 12%. This study reinforces that measures of pulmonary function can be obtained successfully using airwave oscillometry in children with Down syndrome, which supports its use in this high-risk population.
背景
唐氏综合征患儿存在显著的肺部合并症风险，包括反复呼吸道感染、吞咽困难、阻塞性睡眠呼吸暂停和肺血管疾病。由于肺功能的金标准测量方法——肺活量测定法可能不适用于智力残疾的儿童，因此我们试图评估空气波振荡法和肺活量测定法在唐氏综合征患儿中的可行性。
方法
招募了 34 名年龄在 5-17 岁的唐氏综合征患儿。参与者在吸入沙丁胺醇前后进行空气波振荡法和肺活量测定法检查。研究结果包括成功率、支气管扩张前后气道阻力和电抗以及支气管扩张反应。
结果
参与者的中位年龄为 9.2 岁（四分位距 7.2，12.0），47%为男性。空气波振荡法在 26 名参与者中成功（76.5%），4 名（11.8%）成功进行了肺活量测定法。未检测到气道阻力异常，16/26（61.5%）的电抗降低。在成功进行支气管扩张前后检查的 23 名参与者中，有 5 名（21.7%）的空气波振荡法检测到阳性支气管扩张反应。
结论
空气波振荡法成功获得了唐氏综合征患儿的肺功能测量值，支持其在该高风险人群中的应用。
影响
唐氏综合征患儿存在显著的肺部合并症风险，但肺功能的金标准测量方法——肺活量测定法可能不适用于智力残疾的儿童。这可能限制了该人群在临床试验和标准化临床护理中的参与。在这项唐氏综合征患儿肺功能的前瞻性研究中，空气波振荡法在 76%的参与者中成功，但仅在 12%的参与者中成功进行了肺活量测定法。这项研究进一步证实，空气波振荡法可成功获得唐氏综合征患儿的肺功能测量值，支持其在该高风险人群中的应用。
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