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首页> 外文期刊>Clinical and Translational Allergy >Lung function in severe pediatric asthma: a longitudinal study in children and adolescents in Brazil
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Lung function in severe pediatric asthma: a longitudinal study in children and adolescents in Brazil

机译：严重儿童哮喘的肺功能：巴西儿童和青少年的纵向研究

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In severe asthma, high doses of inhaled corticosteroids (ICS) are used in order to achieve clinical and functional control. This study aimed to evaluate lung function in outpatients (children and adolescents) with severe asthma in Brazil, all of whom were treated with high doses of ICS. We evaluated all spirometry tests together and by ICS dose: 800 and >?800?μg/day. This was a 3-year longitudinal study in which we analyzed 384 spirometry tests in 65 severe asthma patients (6–18?years of age), divided into two groups by the dose of ICS (budesonide or equivalent): 800 and >?800?μg/day. At baseline, the forced expiratory volume in one second (FEV1) and the FEV1/forced vital capacity (FVC) ratio were both 800?μg/day group, there were no statistical increases or decreases in FEV1, the FEV1/FVC ratio, or forced expiratory flow between 25 and 75% of the FVC (FEF25–75%), when calculated as percentages of the predicted values. However, the z-score for FEF25–75% showed a statistically significant reduction, in the sample as a whole and in the >?800?μg/day group. Also in the >?800?μg/day group, there was a significant reduction in the post-bronchodilator FEV1% (p?=?0.004). The fact that the spirometric parameters (as percentages of the predicted values) remained constant in the >?800?μg/day group, whereas there was a gain in lung function in the sample as a whole, suggests an early plateau phase in the >?800?μg/day group. However, there was some loss of lung function in the >?800?μg/day group, as evidenced by a decrease in the z-score for FEF25–75%, suggesting irreversible small airway impairment, and by a reduction in the post-bronchodilator FEV1%, suggesting reduced reversibility of airway obstruction. Among children and adolescents with severe asthma, the use of ICS doses higher than those recommended for age does not appear to improve lung function.
机译：在严重哮喘中，为了实现临床和功能控制，应使用大剂量的吸入糖皮质激素（ICS）。这项研究旨在评估巴西患有严重哮喘的门诊患者（儿童和青少年）的肺功能，所有患者均接受高剂量的ICS治疗。我们共同评估了所有肺活量测试，并按ICS剂量（每天800毫克和≥800微克）进行了评估。这是一项为期3年的纵向研究，在该研究中，我们分析了65位重度哮喘患者（6-18岁）的384肺活量检查，按ICS剂量（布地奈德或同等剂量）分为两组：800和> 800微克/天。在基线时，一秒钟的强制呼气量（FEV1）和FEV1 /强制肺活量（FVC）比率均为800μg/ day组，FEV1，FEV1 / FVC比率或以预测值的百分比计算时，强制呼气流量介于FVC的25％至75％之间（FEF25％至75％）。但是，FEF25–75％的z得分在整个样本中和>？800？μg/ day组中显示出统计学上的显着降低。同样在>？800？μg/天的组中，支气管扩张剂后FEV1％明显降低（p？=？0.004）。在>？800？μg/天的组中，肺活量测定参数（占预测值的百分比）保持恒定，而整个样本中的肺功能有所提高，这表明>每天800μg。然而，>？800？μg/天组有一些肺功能丧失，FEF25–75％的z评分降低，表明不可逆的小气道损伤，以及后支气管扩张剂FEV1％，提示气道阻塞可逆性降低。在患有严重哮喘的儿童和青少年中，使用高于建议年龄的ICS剂量似乎不能改善肺功能。

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