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首页> 外文期刊>The journal of asthma >The utility of forced expiratory flow between 25% and 75% of vital capacity in predicting childhood asthma morbidity and severity
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The utility of forced expiratory flow between 25% and 75% of vital capacity in predicting childhood asthma morbidity and severity

机译：肺活量的25％至75％之间的强制呼气流量在预测儿童哮喘的发病率和严重程度中的作用

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Objectives. The forced expiratory volume in 1 second (FEV 1) felt to be an objective measure of airway obstruction is often normal in asthmatic children. The forced expiratory flow between 25% and 75% of vital capacity (FEF 25-75) reflects small airway patency and has been found to be reduced in children with asthma. The aim of this study was to determine whether FEF 25-75 is associated with increased childhood asthma severity and morbidity in the setting of a normal FEV 1, and to determine whether bronchodilator responsiveness (BDR) as defined by FEF 25-75 identifies more childhood asthmatics than does BDR defined by FEV 1. Methods. The Boston Children's Hospital Pulmonary Function Test database was queried and the most recent spirometry result was retrieved for 744 children diagnosed with asthma between 10 and 18 years of age between October 2000 and October 2010. Electronic medical records in the 1 year prior and the 1 year following the date of spirometry were examined for asthma severity (mild, moderate, or severe) and morbidity outcomes for the three age, race, and gender-matched subgroups: Group A (n = 35) had a normal FEV1, FEV 1forced vital capacity (FVC), and FEF 25-75; Group B (n = 36) had solely a diminished FEV 1/FVC; and Group C (n = 37) had a normal FEV 1, low FEV 1/FVC, and low FEF 25-75. Morbidity outcomes analyzed included the presence of hospitalization, emergency department visit, intensive care unit admission, asthma exacerbation, and systemic steroid use. Results. Subjects with a low FEF 25-75 (Group C) had nearly 3 times the odds ratio (OR) (OR = 2.8, p .01) of systemic corticosteroid use and 6 times the OR of asthma exacerbations (OR = 6.3, p .01) compared with those who had normal spirometry (Group A). Using FEF 25-75 to define BDR identified 53 more subjects with asthma than did using a definition based on FEV 1 Conclusions. A low FEF 25-75 in the setting of a normal FEV 1 is associated with increased asthma severity, systemic steroid use, and asthma exacerbations in children. In addition, using the percent change in FEF 25-75 from baseline may be helpful in identifying BDR in asthmatic children with a normal FEV 1.
机译：目标。哮喘儿童通常认为1秒内的呼气量（FEV 1）是客观的气道阻塞指标，通常是正常的。肺活量的25％至75％（FEF 25-75）之间的强制呼气流量反映出较小的气道通畅性，并已发现哮喘儿童的呼气通量减少。这项研究的目的是确定FEF 25-75是否与正常FEV 1背景下儿童哮喘严重程度和发病率增加相关，并确定FEF 25-75定义的支气管扩张剂反应性（BDR）是否能识别更多的儿童比FEV 1定义的BDR哮喘。查询波士顿儿童医院肺功能测试数据库，并检索2000年10月至2010年10月间744名被诊断患有10至18岁哮喘的儿童的最新肺活量测定结果。电子医疗记录在前一年和前一年在进行肺活量测定后，对三个年龄，种族和性别匹配的亚组的哮喘严重程度（轻度，中度或重度）和发病结果进行了检查：A组（n = 35）的FEV1，FEV 1为正常肺活量（FVC）和FEF 25-75; B组（n = 36）的FEV 1 / FVC完全减少; C组（n = 37）的FEV为正常，FEV 1 / FVC较低，FEF为25-75。分析的发病率结果包括住院情况，急诊就诊，重症监护病房入院，哮喘加重和全身性类固醇使用。结果。具有低FEF 25-75的受试者（C组）的全身皮质类固醇使用比值比（OR）（OR = 2.8，p <.01）近3倍，哮喘急性发作的OR是6倍（OR = 6.3，p > 0.01）与肺活量测定正常的患者（A组）进行比较。与基于FEV 1结论的定义相比，使用FEF 25-75定义BDR可以识别出53名哮喘患者。在正常FEV 1的情况下，较低的FEF 25-75与儿童哮喘严重程度增加，全身性类固醇使用和哮喘加重有关。此外，使用FEF 25-75相对于基线的百分比变化可能有助于确定FEV 1正常的哮喘儿童的BDR。

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