Dipartimento Materno Infantile e di Scienze Urologiche, Sapienza Università di Roma, UOC di Pediatria e Neonatologia Ospedale Santa Maria Goretti, Polo Pontino, Roma, Italy.
Ital J Pediatr. 2024 Sep 4;50(1):164. doi: 10.1186/s13052-024-01716-8.
Recently, the development of advanced, noninvasive methods has allowed the study of respiratory function even in uncooperative infants. To date, there is still little data on the application of this technique in infants with suspected airway obstruction.
We enrolled infants aged < 1 year with a diagnosis of inspiratory and/or expiratory chronic stridor and a group of healthy controls. For each patient we performed PFR at diagnosis (T0) and for cases at follow-up, at 3 months (T1), 6 months (T2), 12 months (T3). At T0, all patients were classified according to a clinical score, and at follow-up, stature-ponderal growth was assessed. When clinically indicated, patients underwent bronchoscopy.
We enrolled 48 cases (42 diagnosed with inspiratory stridor and 6 expiratory stridor) and 26 healthy controls. At T0, patients with stridor had increased inspiratory time (p < 0.0001) and expiratory time (p < 0.001) than healthy controls and abnormal curve morphology depending on the type of stridor. At T0, patients with expiratory stridor had a reduced Peak expiratory flow (p < 0.023) and a longer expiratory time (p < 0.004) than patients with inspiratory stridor. We showed an excellent concordance between PFR and endoscopic examination (k = 0.885, p < 0.0001). At follow-up, we showed a progressive increase of the respiratory parameters in line with the growth.
PFR could help improve the management of these patients through rapid and noninvasive diagnosis, careful monitoring, and early detection of those most at risk.
最近，先进的无创方法的发展使得即使是在不合作的婴儿中也能够研究呼吸功能。迄今为止，关于该技术在疑似气道阻塞的婴儿中的应用，数据仍然很少。
我们招募了年龄<1 岁、诊断为吸气性和/或呼气性慢性喘鸣的婴儿和一组健康对照组。对于每个患者，我们在诊断时（T0）进行 PFR，对于有随访的患者，在 3 个月（T1）、6 个月（T2）、12 个月（T3）时进行 PFR。在 T0 时，所有患者根据临床评分进行分类，在随访时，评估身高体重增长情况。当临床需要时，患者进行支气管镜检查。
我们共招募了 48 例病例（42 例诊断为吸气性喘鸣，6 例为呼气性喘鸣）和 26 名健康对照组。在 T0 时，喘鸣患者的吸气时间（p<0.0001）和呼气时间（p<0.001）均长于健康对照组，并且根据喘鸣类型出现异常的曲线形态。在 T0 时，呼气性喘鸣患者的呼气峰流速（p<0.023）较低，呼气时间（p<0.004）较长。我们发现 PFR 和内窥镜检查之间具有极好的一致性（k=0.885，p<0.0001）。在随访时，我们发现呼吸参数随着生长而逐渐增加。
PFR 通过快速、无创的诊断、仔细的监测和早期发现高危患者，有助于改善这些患者的管理。
