急性胸部综合征对于镰刀状红细胞贫血患儿肺功能的影响

摘要

Objective:To test the hypothesis that children with sicklecell disease (SCD) who experienced an acute chest syndrome(ACS) hospitalization episode would have worse lung function than children with SCD without ACS episodes. Study design:Forced expiratory volume in 1 second (FEV1); forced vitalcapacity (FVC); FEV1/FVC ratio; peak expiratory flow (PEF);forced expiratory flow at 25%(FEF25),50%(FEF50),and 75%(FEF75) of FVC; airway resistance (Raw); and lung volumes were compared in 20 children with ACS and 20 aged-matched children without ACS (median age,11 years; range,6 to 16 years). Fourteen age-matched pairs were assessed before and after bronchodilator use. Results:The mean Raw (P = 0.03),TLC (P = 0.01),and RV (P = 0.003) were significantly higher in the group with ACS than in the group without ACS. There were no significant differences in the changes in lung function test results in response to bronchodilator administration between the 2 groups,but the children with ACS had a lower FEF25 (P = 0.04) and FEF75 (P = 0.03) pre-bronchodilator use and a lower mean FEV1/FVC ratio (P = 0.03) and FEF75 (P =0.03) post-bronchodilator use. Conclusions:Children with SCD who experienced an ACS hospitalization episode had significant differences in lung function compared with those who did not experience ACS episodes. Our results are compatible with the hypothesis that ACS episodes predispose children to increased airway obstruction.