Altitude Pediatric Asthma Centre in Misurina, Pio XII Institute, Belluno, Italy.
Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy.
Pediatr Pulmonol. 2022 Sep;57(9):2116-2121. doi: 10.1002/ppul.25987. Epub 2022 Jun 6.
Lung function is a central issue in diagnosis and determination of asthma severity and asthma control has been previously reported to improve after a stay in mountain environment for at least 2 weeks. No data are available for shorter periods of stay, in particular for small airways during a stay at altitude. The aim of this study is to focus on changes in respiratory function, regarding both the central airways and the peripheral airways in the first 2 weeks of stay in a mountain environment in asthmatic children. In this study, 66 asthmatic children (age: 14 ± 2.8 years) were evaluated through spirometric and oscillometric tests at the time of arrival at the Istituto Pio XII, Misurina (BL), Italy, 1756 m above sea level (T0), after 24 h (T1), and 168 h (T2) of stay. FEV1%, FEF25%-75%, and FEV1/FVC increased significantly from T0 value both at T1 and T2 (respectively, p = 0.0002, p < 0.0001, p = 0.0002). Oscillometry showed a significant improvement in R5, R20, and R5-20 at both T1 and T2 as compared to T0 (respectively, p = 0.0001, p = 0.0002, and p = 0.049). Reactance at 5 Hz (X5) improved significantly at T2 versus T0, p = 0.0022. The area under reactance curve between Fres and 5 Hz (AX) was significantly reduced (p = 0.0001) both at T1 and T2 as compared to T0. This study shows an improvement in respiratory indices as soon as after 24 h of stay at altitude, persisting in the following week.
肺功能是诊断和确定哮喘严重程度的核心问题,此前有报道称,在山区环境中至少停留 2 周后,哮喘控制情况会得到改善。但是对于停留时间较短的情况,特别是在高海拔地区停留期间的小气道,目前尚无相关数据。本研究旨在关注哮喘儿童在山区环境中停留的前 2 周内,呼吸功能的变化,包括中央气道和外周气道。在这项研究中,66 名哮喘儿童(年龄:14±2.8 岁)在抵达意大利特伦蒂诺-上阿迪杰大区密苏里纳的皮乌斯十二世研究所(BL)时,在海拔 1756 米处(T0),经过 24 小时(T1)和 168 小时(T2)的停留后,通过肺活量计和振荡测量法进行了评估。FEV1%、FEF25%-75%和 FEV1/FVC 在 T1 和 T2 时均较 T0 值显著增加(分别为 p=0.0002、p<0.0001、p=0.0002)。与 T0 相比,振荡测量法在 T1 和 T2 时,R5、R20 和 R5-20 均显著改善(分别为 p=0.0001、p=0.0002 和 p=0.049)。在 T2 时,5 赫兹(X5)的电抗显著改善,与 T0 相比,p=0.0022。与 T0 相比,在 T1 和 T2 时,Fres 和 5 赫兹之间的电抗曲线下面积(AX)显著降低(p=0.0001)。本研究表明,在高海拔地区停留 24 小时后,呼吸指数即得到改善,并且在接下来的一周内持续改善。