慢性非特异性肺部疾病合并肺纤维化患儿肺功能指标的研究

E. Knizhnikova, G. Evseeva, V. V. Polubartseva, S. V. Pichuginа, S. Anureev, S. Suprun, O. Lebed’ko
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摘要

介绍。大多数儿童慢性非特异性肺部疾病(CNSLD)的发病机制是基于一个长期的炎症过程,往往导致结构改变组织中形成肺纤维化,这需要对患者进行动态监测,包括肺功能的研究。目的探讨慢性支气管肺病理伴肺纤维化患儿肺功能指标。材料和方法。对84例CNSLD患儿进行了检查。主要组包括45例伴有肺纤维化的CNSLD患儿(支气管肺发育不良、先天性肺畸形、慢性支气管炎和肺炎后纤维化)。对照组为39例无肺纤维化的CNSLD患儿。研究组儿童平均年龄为9.3±0.48岁。患者接受肺部多螺旋计算机断层扫描,虚拟支气管镜程序和静脉注射造影剂增强。肺活量测定法评价肺功能。在缓解期患者中,两组患者肺通气量平均值均在预测值内。而在有肺纤维化改变的患儿中,肺功能障碍的检出率是无肺纤维化患儿的2倍(分别为35.5%和15.4%,p<0.05)。限制性通气障碍仅在肺纤维化患者组中被诊断。合并肺纤维化的患儿通气能力降低的风险显著高于未合并肺纤维化的患儿(OR=3.04, 95% CI 1.049 ~ 8.78)。获得的数据可以作为进一步发展预测疾病病程性质的先决条件,确定纤维化改变发展的“风险群体”,为CNSLD患者的个性化治疗和随访提供方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Indicators of lung function in children with chronic nonspecific lung diseases with pulmonary fibrosis
Introduction. The pathogenesis of most chronic nonspecific lung diseases (CNSLD) in children is based on a long-term inflammatory process, often leading to the formation of pulmonary fibrosis in the structurally altered tissue, which requires dynamic monitoring of patients, including the study of lung function.Aim. To assess the indicators of the lung function in children with chronic bronchopulmonary pathology accompanied by pulmonary fibrosis.Materials and methods. 84 children with CNSLD were examined. The main group consisted of 45 children with CNSLD with pulmonary fibrosis (bronchopulmonary dysplasia, congenital malformations of the lungs, chronic bronchitis, and post pneumonia fibrosis). The comparison group consisted of 39 children with CNSLD without pulmonary fibrosis. The average age of children in the study groups was 9,3±0,48 years. The patients underwent multispiral computed tomography of the lungs with a virtual bronchoscopy program and intravenous bolus contrast enhancement. Evaluation of lung function was carried out by spirometry.Results. In patients in remission, the average values of the ventilation capacity of the lungs in both groups were within the predicted values. However, in patients with fibrotic changes, pulmonary dysfunction was detected 2 times more often than in children with CNSLD without pulmonary fibrosis (35.5% and 15.4%, respectively, p<0.05). Restrictive ventilation disorders were diagnosed only in the group of patients with pulmonary fibrosis. In children with pulmonary fibrosis, the risk of reduced ventilation capacity is significantly higher than in children with CNSLD without pulmonary fibrosis (OR=3.04, 95% CI 1.049–8.78).Conclusion. The data obtained can serve as a prerequisite for further development of predicting the nature of the course of the disease, identifying “risk groups” for the development of fibrotic changes for a personalized approach to the treatment and follow-up of patients with CNSLD.
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