FEF25-75 在临床实践中管理新诊断哮喘儿童的作用。
Role of FEF25-75 in managing children with newly-diagnosed asthma in clinical practice.
机构信息
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出版信息
Acta Biomed. 2022 Aug 31;93(4):e2022276. doi: 10.23750/abm.v93i4.12550.
Background Reversible bronchial obstruction characterizes asthma. Spirometry is the gold standard to assess airflow, and FEV1 is the most reliable parameter in this regard. However, many children with asthma have FEV1 within the normal range despite uncontrolled asthma and worsening. Therefore, FEF25-75 has been proposed as a valuable marker of early airflow impairment. This study aimed at investigating FEF25-75 in a cohort of children with newly diagnosed asthma. Methods 381 children (122 females, mean age 11.6 years) were consecutively visited and had a new asthma diagnosis. In addition, Spirometry, type-2 phenotyping, asthma control assessment, and ACT were performed. Results 72 (18.9%) asthmatic children had impaired FEF25-75, such as <65% of predicted. Low FEF25-75 was associated with lower FVC and FEV1/FVC values (OR 1.11 and 1.32, respectively). Children with normal FEV1 but impaired FEF25-75 had more frequently uncontrolled asthma (15.8% vs. 32.4%) than children with both parameters within the normal range. Conclusions FEF25-75 deserves adequate and careful consideration in children with asthma, and the presence of impaired FEF25-75 values suggests a more compelling approach.
背景
哮喘的特征是可逆性支气管阻塞。肺量测定法是评估气流的金标准，而 FEV1 是这方面最可靠的参数。然而，许多哮喘儿童的 FEV1 在正常范围内，尽管哮喘未得到控制且病情恶化。因此，FEF25-75 已被提议作为早期气流受损的有价值标志物。本研究旨在调查新诊断哮喘儿童队列中的 FEF25-75。
方法
连续就诊的 381 名儿童（122 名女性，平均年龄 11.6 岁）被诊断为新的哮喘。此外，还进行了肺量测定法、2 型表型鉴定、哮喘控制评估和 ACT。
结果
72 名（18.9%）哮喘儿童的 FEF25-75 受损，例如<65%预计值。低 FEF25-75 与较低的 FVC 和 FEV1/FVC 值相关（OR 分别为 1.11 和 1.32）。FEV1 正常但 FEF25-75 受损的儿童较 FEV1 和 FEF25-75 均正常的儿童更频繁地出现未控制的哮喘（15.8%比 32.4%）。
结论
FEF25-75 在哮喘儿童中值得充分和仔细考虑，FEF25-75 值受损表明需要更有力的治疗方法。
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