Pediatr Pulmonol:支气管肺发育不良和哮喘儿童在激发试验、气道炎症和肺功能之间有何异同?

2017-06-26 fengxiangxin MedSci原创

目前还没有建立对前早产儿支气管肺发育不良(BPD)的长期呼吸特征的研究。本研究的目的是描述与学龄儿童特应性哮喘相比,BPD的特征。研究结果发表在最新一期医学儿科知名期刊Pediatr Pulmonol上。

目前还没有建立对前早产儿支气管肺发育不良(BPD)的长期呼吸特征的研究。本研究的目的是描述与学龄儿童特应性哮喘相比,BPD的特征。研究结果发表在最新一期医学儿科知名期刊Pediatr Pulmonol上。

本研究为基于医院设定的横断面描述性比较研究。研究者分析了30名诊断有BPD的学龄儿童(平均年龄10.4,于妊娠26.6周出生)和30名年龄和性别匹配的空气过敏原敏感哮喘患儿(IgE> 0.35kUA /L)。测量项目包括呼出气一氧化氮(FENO,PPB),动静态肺功能测定及乙酰甲胆碱(PD :20)、甘露醇(PD: 15)支气管激发试验,并且使用儿童哮喘控制测试(C-ACT)对呼吸系统症状进行评分。

与哮喘儿童相比,BPD儿童的肺功能指标(FEV1 %: 77 vs 84,FEV1/FVC % :85 vs 91,FEF50 % :61 vs 80)和一氧化碳弥散量(DLCO %:8 vs 88)均较低(P值<0.042)。此外,BPD儿童的FENO值也显著低于哮喘儿童(12 vs 23 ,P= 0.019)。乙酰甲胆碱试验阳性比例在两者之间具有可比性(74% vs 93%,P = 0.14)。然而,BPD组儿童对甘露醇的反应(19% vs 61%,P = 0.007)和自我报告症状均更少(C-ACT,中位数:26 vs 24,P = 0.003)。

在学龄期BPD儿童的呼吸特点为肺功能减退,对甘露醇间接激发试验的反应受限,但对乙酰甲胆碱的直接激发和弥散功能损伤有高反应性。与过敏性哮喘儿童相比,BPD患儿气道炎症的证据较少。

原始出处:

Nordlund, B., A. James, C. Ebersjo, et al., Differences and similarities between bronchopulmonary dysplasia and asthma in schoolchildren. Pediatr Pulmonol, 2017 Jun 21. doi: 10.1002/ppul.23741.

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    2017-06-28 neurowu
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