与出生体重极低、有或者没有支气管肺发育不良的学龄儿童哮喘相关的临床变量之间的关联
2016/11/09
摘要
目的：在出生体重极低、有或者没有支气管肺发育不良的学龄哮喘儿童中评估患病率、肺活量和危险因素。
方法：观测与横断面研究。父母和/或导师回答了国际儿童哮喘和过敏的调查问卷调查。小学生进行皮肤点刺试验和肺功能评估。
结果：54个学生出生时体重极低，其中43个达到了肺活量测定的标准。在支气管肺发育不良组，年龄（支气管肺发育不良= 9.5±0.85；无支气管肺发育不良=10.1±0.86岁）和出生体重（支气管肺发育不良=916.7±251.2 = 1171.3；无支气管肺发育不良=1,171.3±190.5g）均较低（P＜0.05）。极低出生体重儿哮喘的发病率为17／54（31.5%），在支气管肺发育不良组为6 / 18（33.3%）。在生命的第一年（p=0.026）使用毛毯与上学后患哮喘之间有关联。皮肤刺试验阳性在哮喘和无哮喘组中分别为13 / 17（76.5%）和23 / 37（62.2%）。有哮喘的学龄儿童(n=16; -1.04±1.19)与无哮喘的患者 (n=27; -0.38±0.93)比较，在25%和75%的用力肺活量之间的用力呼气流量有较低的Z值(p=0.049)。在支气管肺发育不良组或无不良组中肺功能变量之间没有区别。
结论：极低出生体重、有或者没有支气管肺发育不良的婴儿哮喘发病率均较高（分别为33.3%和30.6%）。哮喘患儿的小气道内的肺动脉血流较低。
关键词：ASMA；哮喘；支气管发育不良；早产
（杨冬 审校）
Rev Paul Pediatr. 2016 Sep;34(3):271-80. doi: 10.1016/j.rpped.2015.12.005. Epub 2016 Feb 17.
Association between clinical variables related to asthma in schoolchildren born with very low birth weight with and without bronchopulmonary dysplasia.
[Article in English, Portuguese]
Gonçalves Eda S1, Mezzacappa-Filho F2, Severino SD2, Ribeiro MÂ2, Marson FA2, Morcilo AM2, Toro AA2, Ribeiro JD2.
Author information
Abstract
OBJECTIVE:to assess the prevalence, spirometry findings and risk factors for asthma in schoolchildren who were very low birth weight infants with and without bronchopulmonary dysplasia.
METHODS:Observational and cross-sectional study. The parents and/or tutors answered the International Study of Asthma and Allergies in Childhood questionnaire. The schoolchildren were submitted to the skin prick test and spirometry assessment.
RESULTS:54 schoolchildren who were very low birth weight infants were assessed and 43 met the criteria for spirometry. Age at the assessment (bronchopulmonary dysplasia=9.5±0.85; without bronchopulmonary dysplasia=10.1±0.86 years) and birth weight (bronchopulmonary dysplasia=916.7±251.2; without bronchopulmonary dysplasia=1,171.3±190.5g) were lower in the group with bronchopulmonary dysplasia (p<0.05). The prevalence of asthma among very low birth weight infants was 17/54 (31.5%), being 6/18 (33.3%) in the group with bronchopulmonary dysplasia. There was an association between wool blanket use in the first year of life (p=0.026) with the presence of asthma at school age. The skin prick test was positive in 13/17 (76.5%) and 23/37 (62.2%) of patients with and without asthma, respectively. The schoolchildren with asthmahad lower z-score values of forced expiratory flow between 25% and 75% of forced vital capacity (n=16; -1.04±1.19) when compared to the group of patients without asthma (n=27; -0.38±0.93) (p=0.049). There was no difference between the spirometry variables in the groups regarding the presence or absence of bronchopulmonary dysplasia.
CONCLUSIONS:Very low birth weight infants with and without bronchopulmonary dysplasia showed a high prevalence of asthma (33.3% and 30.6%, respectively). Pulmonary flow in the small airways was lower in children with asthma.
Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
KEYWORDS:Asma; Asthma; Bronchopulmonary dysplasia; Displasia broncopulmonar; Nascimento prematuro; Preterm birth
Rev Paul Pediatr. 2016 Sep;34(3):271-80. doi: 10.1016/j.rpped.2015.12.005. Epub 2016 Feb 17.
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