诊断延迟对哮喘患儿肺功能的影响。
Effect of diagnosis delay on pulmonary function in children with asthma.
作者信息
Wei Xiaoling, Xue Min, Yan Jinyan, Han Yuling, Liu Yanqin, Liu Miao, Sun Jing, Zhang Yun, Cheng Lu, Ma Xiang, Gai Zhongtao
机构信息
Department of Respiratory Diseases, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, 250022, Shandong, China.
Jinan Institute of Pediatric Research, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, 250022, Shandong, China.
出版信息
Allergy Asthma Clin Immunol. 2022 Oct 19;18(1):92. doi: 10.1186/s13223-022-00731-w.
BACKGROUND
The effects of a delayed diagnosis of asthma on lung function in children have not been well investigated. Therefore, a retrospective cohort study was conducted in a children's hospital to analyse the effect of delayed diagnosis time on lung function in children with asthma.
METHODS
We conducted a retrospective cohort study in Jinan Children's Hospital from January 1, 2010, to December 31, 2020. All children were divided into different groups according to the presence or absence of rhinitis, age at first onset (first coughing and wheezing attack) and delayed diagnosis duration (≤ 3 months, 3-12 months, 1-3 years, 3-5 years and > 5 years).
RESULTS
A total of 1,014 children with asthma were included in this study. The median (quartile) delay in asthma diagnosis among all participants was 11 (2, 26) months. The shortest delay in diagnosis time was on the same day of onset, and the longest delay in diagnosis time was 10 years. The median (quartile) duration of delayed diagnosis was 10 (2, 26) months in 307 asthmatic children without rhinitis and 11 (2, 26) months in 707 children with asthma and rhinitis (P < 0.05). The delayed diagnosis time was shorter among female children than among male children (P < 0.05), and the first %predicted forced volume capacity (FVC%pred) results for females were higher than those for males (P = 0.036). The children whose age at first asthma onset was ≤ 3 years had a longer delayed diagnosis duration than those whose age at first onset was > 3 years (P < 0.05). The FVC%pred and %predicted forced expiratory volume in 1 s (FEV1%pred) in the first and second pulmonary function tests were significantly lower in the five delayed diagnosis groups (all P < 0.05). After standardised treatment for 3-6 months, FVC%pred showed a significant difference in the third test among the 5 groups (P < 0.05), but the other pulmonary function indices showed no significant difference. Logistic regression analysis showed that longer delay and young age of onset were associated with lower lung function (P < 0.05), whereas sex, rhinitis and eczema had no significant effects (all P > 0.05) on FVC%pred and FEV1%pred.
CONCLUSION
Although delayed asthma diagnosis can lead to lung function impairment in children with asthma, lung function can be improved quickly after standardised treatment. Therefore, early asthma diagnosis and standardised treatment are very important.
背景
哮喘延迟诊断对儿童肺功能的影响尚未得到充分研究。因此，在一家儿童医院进行了一项回顾性队列研究，以分析延迟诊断时间对哮喘儿童肺功能的影响。
方法
我们于2010年1月1日至2020年12月31日在济南市儿童医院进行了一项回顾性队列研究。所有儿童根据是否患有鼻炎、首次发病年龄（首次咳嗽和喘息发作）以及延迟诊断持续时间（≤3个月、3 - 12个月、1 - 3年、3 - 5年和>5年）分为不同组。
结果
本研究共纳入1014例哮喘儿童。所有参与者哮喘诊断的中位（四分位数）延迟时间为11（2，26）个月。最短诊断延迟时间为发病当天，最长诊断延迟时间为10年。307例无鼻炎的哮喘儿童延迟诊断的中位（四分位数）持续时间为10（2，26）个月，707例有鼻炎的哮喘儿童为11（2，26）个月（P<0.05）。女童的延迟诊断时间短于男童（P<0.05），且女童的首次预测用力肺活量百分比（FVC%pred）结果高于男童（P = 0.036）。首次哮喘发病年龄≤3岁的儿童延迟诊断持续时间长于首次发病年龄>3岁的儿童（P<0.05）。在五个延迟诊断组中，第一次和第二次肺功能测试中的FVC%pred和1秒用力呼气量百分比（FEV1%pred）均显著较低（均P<0.05）。经过3 - 6个月的标准化治疗后，5组中第三次测试的FVC%pred显示出显著差异（P<0.05），但其他肺功能指标无显著差异。Logistic回归分析表明，延迟时间越长和发病年龄越小与肺功能越低相关（P<0.05），而性别、鼻炎和湿疹对FVC%pred和FEV1%pred无显著影响（均P>0.05）。
结论
虽然哮喘延迟诊断会导致哮喘儿童肺功能受损，但标准化治疗后肺功能可迅速改善。因此，早期哮喘诊断和标准化治疗非常重要。
Zotero 插件