Zhao Xiaowei, Zhao Yuqi, Ding Guoyu, Li Xue, Zhang Xiaoyue, Leng Yanli, Wang Hongmei
Department of Pediatrics The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital jinan Shandong China.
College of Clinical Medicine Jining Medical University jining Shandong China.
Health Sci Rep. 2025 Jan 22;8(1):e70365. doi: 10.1002/hsr2.70365. eCollection 2025 Jan.
Hematopoietic stem cell transplantation (HSCT) is a key therapeutic approach for pediatric patients with hematologic and non-hematologic disorders. However, post-transplant pulmonary complications remain a significant cause of morbidity and mortality. Pulmonary Function Tests (PFTs) are essential for the early detection of pulmonary dysfunction, yet their application in pediatric HSCT recipients has yielded inconsistent results. This review aims to assess the variations in pulmonary function post-HSCT and explore their clinical implications for pediatric patients.
A systematic review was conducted by analyzing studies published between 2000 and 2024, sourced from PubMed, Web of Science, CNKI, and Wan Fang databases. The review included cohort studies, randomized controlled trials, and case-control studies that assessed pulmonary function using standardized PFTs.
Pulmonary dysfunction, particularly obstructive and restrictive ventilatory disorders, is common in pediatric HSCT recipients. Significant changes in PFT parameters, such as FEV1/FVC ratio and FEF25-75%, were observed. However, trends in post-transplant pulmonary function vary due to factors such as pre-transplant lung conditions, patient age, and treatment protocols. Innovative diagnostic methods, such as parametric response mapping (PRM) and multiple breath washout (MBW), show promise in enhancing early detection and management of pulmonary complications.
Monitoring pulmonary function is critical for the early identification of complications in pediatric HSCT recipients. Although standardized clinical guidelines are available, variability in PFT trends underscores the need for more refined diagnostic tools. Advanced diagnostic methods, like PRM and MBW, may improve early detection and help optimize the management of pulmonary dysfunction, ultimately improving long-term outcomes for pediatric patients.
造血干细胞移植（HSCT）是患有血液系统和非血液系统疾病的儿科患者的关键治疗方法。然而，移植后肺部并发症仍然是发病和死亡的重要原因。肺功能测试（PFT）对于早期发现肺功能障碍至关重要，但其在儿科HSCT受者中的应用结果并不一致。本综述旨在评估HSCT后肺功能的变化，并探讨其对儿科患者的临床意义。
通过分析2000年至2024年发表的研究进行系统综述，这些研究来自PubMed、科学网、中国知网和万方数据库。该综述纳入了使用标准化PFT评估肺功能的队列研究、随机对照试验和病例对照研究。
肺功能障碍，尤其是阻塞性和限制性通气障碍，在儿科HSCT受者中很常见。观察到PFT参数如FEV1/FVC比值和FEF25-75%有显著变化。然而，由于移植前肺部状况、患者年龄和治疗方案等因素，移植后肺功能的趋势各不相同。创新的诊断方法，如参数反应映射（PRM）和多次呼气冲洗（MBW），在加强肺部并发症的早期检测和管理方面显示出前景。
监测肺功能对于早期识别儿科HSCT受者的并发症至关重要。虽然有标准化的临床指南，但PFT趋势的变异性强调了需要更精细的诊断工具。像PRM和MBW这样的先进诊断方法可能会改善早期检测，并有助于优化肺功能障碍的管理，最终改善儿科患者的长期预后。
