目的 分析超重/肥胖对反复喘息婴幼儿潮气肺功能的影响,为哮喘的预防和管理奠定基础。方法 选择在广东省妇幼保健院儿童呼吸科就诊的100例0～3岁反复喘息的急性发作期患儿为研究对象,按体重指数(BMI)分为喘息非超重组70例、喘息超重/肥胖组30例;选择80例0～3岁无呼吸系统疾病婴幼儿为对照组,其中非超重组50例,超重/肥胖组30例。测定各组受试患儿潮气呼吸流量-容积曲线(TBFV),记录各参数并进行比较。结果 喘息非超重组与对照非超重组比较,达峰时间比(TPTEF/TE)、达峰容积比(VPTEF/VE)、吸呼比(TI∶TE)、呼出75%潮气量时的呼气流速/呼气峰流速(25/PF)均明显下降 (t＝8.518、7.767、3.142、7.860,P＜0.05);呼气峰流速(PTEF)、呼出25%潮气量时的呼气流量(TEF75)显著增加(t=6.728、8.540,P＜0.05)。分别在对照组、喘息组中,与非超重儿童肺功能参数相比,超重/肥胖儿童仅潮气量(VT/kg)显著下降(t=2.872、3.048,P＜0.05)。结论 超重/肥胖影响婴幼儿肺功能潮气量(VT/kg),但不影响气道阻塞的指标。
Abstract
Objective To investigate the effect of overweight and obesity on tidal lung function of infants with recurrent wheezing,in order to provide evidence for the prevention and control of asthma. Methods A total of 100 children aged 0 to 3 years with recurrent wheezing were selected in this study from Child Respiratory Department in Guangdong Women and Children Hospital. According to body mass index (BMI),wheezing children were divided into non-overweight group (n=70) and overweight/obesity group (n=30). And 80 children aged 0 to 3 years without respiratory diseases were selected as control group and divided into non-overweight group (n=50) and overweight/obesity group(n=30) according to BMI. The tidal breathing parameters and flow-volume loop of infants in each group were recorded and compared. Results The values oftime to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE),volume to peak expiratory flow as a proportion of exhaled volume(VPTEF/VE),inspiratory time/expiratory time(TI∶TE),tidal expiratory flow when 25% of tidal volune remain in the lung/peak tidal expiratory flow(25/PF) of the wheezing infants with non-overweight significantly decreased compared with the control group without wheezing (t=8.518,7.767,3.142,7.860,P<0.05),while peak tidal expiratory flow(PTEF),tidal expiratory flow when 75% of tidal volume remains in the lung(TEF75) increased (t=6.728,8.540,P<0.05). In the control group and the wheezing group,compared with the non-overweight infants,tidal volume/kg(VT/kg) of infants with overweight and obesity decreased (t=2.872,3.048,P<0.05). Conclusion Overweight and obesity have impacts on VT/kg of tidal lung function,but did not affect airway obstruction indicators.
关键词
超重/肥胖 /
潮气肺功能 /
反复喘息 /
幼儿
Key words
overweight and obesity /
tidal lung function /
recurrent wheezing /
infants
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参考文献
[1] Deng XL,Ma J,Yuan Y,et al.Association between overweight or obesity and the risk for childhood asthma and wheeze:An updated meta-analysis on 18 articles and 73 252 children[J].Pediatr Obes,2019,14(9):e12532.
[2] Lang JE,Bunnell HT,Hossain MJ,et al.Being overweight or obese and the development of asthma[J].Pediatrics,2018,142(6):e20182119.
[3] Forno E,Han YY,Mullen J,et al.Overweight,obesity,and lung function in children and adults-A meta-analysis[J].J Allergy ClinImmunol Pract Mar-Apr,2018,6(2):570-581.
[4] Paciência I,CavaleiroRufo J,Silva D,et al.Exposure to indoor endocrine-disrupting chemicals and childhood asthma and obesity[J].Allergy,2019,74(7):1277-1291.
[5] Peters U,Dixon AE,Forno E. Obesity and asthma[J].J Allergy Clin Immunol,2018,141(4):1169-1179.
[6] Mohan A,Grace J,Wang BR. The effects of obesity in asthma[J].Curr Allergy Asthma Rep,2019,19(10):49.
[7] Scott HA,Wood LG,Gibson PG.Role of obesity in asthma:mechanisms and management strategies[J].Curr Allergy Asthma Rep,2017,17(8):53.
[8] Bobolea I,Arismendi E,Valero A,et al.Early life origins of asthma:a review of potential effectors[J].J Investig Allergol Clin Immunol,2019,29(3):168-179.
[9] Bonato M,Tiné M,Bazzan E. Early airway pathological changes in children:new insights into thenatural history of wheezing[J].J Clin Med,2019,8(8):1180.
[10] Hassan MZ,Chowdhury MAB,Hassan I,et al.Respiratory viral infection in early life and development of asthma in childhood:A protocol for systematic review and meta-analysis[J].Medicine,2019,98(18):e15419.
[11] 中华医学会儿科学分会呼吸学组肺功能协作组,《中华实用儿科临床杂志》编辑委员会. 儿童肺功能系列指南(四):潮气呼吸肺功能[J].中华实用儿科临床杂志,2016,31(21):1617-1621
[12] 聂晖,韦红.潮气呼吸肺功能测定在婴幼儿喘息性疾病中的应用及意义[J].国际呼吸杂志,2016, 36(13):1020-1022.
[13] 何春卉,邓力,黄旭强,等.广州地区 1—3岁健康幼儿肺功能测定结果的探讨[J].中国循证儿科杂志,2007,2(1):21-26.
[14] Qi YY,Jiang GL,Wang LB,et al.Lung function in wheezing infants after acute lower respiratory tract infection and its association with respiratory outcome[J].Chin Med J,2017,130(1):4-10.
[15] Hevroni A,Goldman A,Blank-Brachfeld M.Use of tidal breathing curves for evaluating expiratory airway obstruction in infants[J].J Asthma,2018,55(12):1331-1337.
[16] 赵艳,黄英,罗蓉,等,反复喘息婴幼儿潮气呼吸肺功能及其与生长的相关性[J].临床儿科杂志,2017,35(8):561-564..
[17] Dixon AE,Peters U.The effect of obesity on lung function[J].Expert Rev Respir Med,2018,12(9):755-767.
[18] Kasteleyn MJ,Bonten TN,de Mutsert R,et al.Pulmonary function,exhaled nitric oxide and symptoms in asthma patients with obesity:a cross-sectional study[J].Respir Res,2017,18(1):205.
[19] 徐晓雯,黄英,王健,等.肥胖对不同年龄段哮喘患儿肺功能的影响[J].中国当代儿科杂志,2017,19(5):519-523.
[20] Yao TC,Tsai HJ,Chang SW,et al.Obesity disproportionately impacts lung volumes,airflow and exhaled nitric oxide in children[J].PLoS One,2017,12(4):e0174691.
[21] Kim JY,Sohn JH,Lee JH,et al.Obesity increases airway hyperresponsiveness via the TNF-α pathway and treating obesity induces recovery[J].PLoS One,2015,10(2):e0116540.
[22] Gruchała-Niedoszytko M,Małgorzewicz S,Niedoszytko M,et al.The influence of obesity on inflammation and clinical symptoms in asthma[J].Adv Med Sci,2013,58(1):15-21.
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