电子居家监测囊性纤维化患儿以发现和治疗急性肺部加重及其对 1 年 FEV 的影响。
Electronic home monitoring of children with cystic fibrosis to detect and treat acute pulmonary exacerbations and its effect on 1-year FEV.
机构信息
Division of Pediatric Pulmonology, Marmara University School of Medicine, Fevzi Çakmak mahallesi, Muhsin Yazıcıoğlu caddesi, No:10, Pendik, Istanbul 34899, Turkey.
Division of Pediatric Pulmonology, Marmara University School of Medicine, Fevzi Çakmak mahallesi, Muhsin Yazıcıoğlu caddesi, No:10, Pendik, Istanbul 34899, Turkey.
出版信息
J Cyst Fibros. 2024 Mar;23(2):329-333. doi: 10.1016/j.jcf.2023.09.007. Epub 2023 Sep 23.
BACKGROUND
We aimed to investigate the effect of the use of electronic home spirometry in children with cystic fibrosis (CF) on 1-year FEV (% predicted, pp) change.
METHODS
This is a randomised, one-year prospective study including children with CF between 6 and 18 years of age. Subjects were randomised into home spirometry group (HSG) and usual care group (UCG). Children in HSG performed two pulmonary function tests (PFT) per week. Data regarding acute pulmonary exacerbations (PEx) was obtained from patients' records. At baseline and 12th month, health related quality of life questionnaire for CF patients (CFQ-R) and lung clearance index (LCI) were performed.
RESULTS
Sixty children were recruited with a median (IQR) age of 13.3 (11.4-15.4) years. Absolute change in FEVpp from baseline to 12th month as median (IQR) was +1% (-6.75-9.75) in HSG and -2.50% (-7.50-3.25) in UCG (p = 0.10). Sensitivity analysis including only adherent children in HSG (n = 22), yielded an increase of 5% (-3.50-12) in HSG and a decrease of 2.50% (-7.50-3.25) in UCG (p = 0.009). A total of 29 (96.7%) subjects in HSG and 23 (76.7%) in UCG had PEx (p = 0.05). Absolute change in median (IQR) LCI from baseline to the 12th month was -1.6 [-2.9-0] (p<0.001) in HSG and -1.5 [-2.8-(-0.6)] (p<0.001) in UCG (p = 0.94). There was a significant increase in the social domain of the CFQ-R in HSG (from 59.1 to 76.2, p = 0.01).
CONCLUSIONS
Electronic home monitoring of children with CF by spirometry may result in improvement in lung function.
背景
本研究旨在探讨电子家庭肺量计在囊性纤维化（CF）儿童中的应用对 1 年 FEV（预计值的百分比，pp）变化的影响。
方法
这是一项为期 1 年的随机前瞻性研究，纳入年龄在 6 至 18 岁之间的 CF 患儿。将受试者随机分为家庭肺量计组（HSG）和常规护理组（UCG）。HSG 组患儿每周进行两次肺功能检查（PFT）。通过患者病历获取急性肺部加重（PEx）的数据。在基线和第 12 个月时，进行 CF 患者健康相关生活质量问卷（CFQ-R）和肺清除指数（LCI）检测。
结果
共纳入 60 名患儿，中位（IQR）年龄为 13.3（11.4-15.4）岁。HSG 组的 FEVpp 绝对值从基线到 12 个月的变化中位数（IQR）为+1%（-6.75-9.75），而 UCG 组为-2.50%（-7.50-3.25）（p=0.10）。对 HSG 中仅依从性良好的儿童进行敏感性分析（n=22），结果显示 HSG 组增加了 5%（-3.50-12），而 UCG 组减少了 2.50%（-7.50-3.25）（p=0.009）。HSG 组有 29 名（96.7%）受试者和 UCG 组有 23 名（76.7%）受试者发生 PEx（p=0.05）。从基线到第 12 个月，HSG 组和 UCG 组的 LCI 中位数（IQR）绝对值变化分别为-1.6[-2.9-0]（p<0.001）和-1.5[-2.8-（-0.6）]（p<0.001）（p=0.94）。HSG 组 CFQ-R 的社会领域得分显著升高（从 59.1 分升至 76.2 分，p=0.01）。
结论
通过肺量计对 CF 患儿进行电子家庭监测可能会改善肺功能。
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