Exercise flow-volume loops in prepubescent aerobically trained children.

We studied mechanical ventilatory constraints in 13 aerobically trained (Tr) and 11 untrained (UT) prepubescent children by plotting the exercise flow-volume (F-V) loops within the maximal F-V loop (MFVL) measured at rest. The MFVL allowed to determine forced vital capacity (FVC) and maximal expiratory flows. Expiratory and inspiratory reserve volumes relative to FVC (ERV/FVC and IRV/FVC, respectively) were measured during a progressive exercise test until exhaustion. Breathing reserve (BR) and expiratory flow limitation (expFL), expressed in percentage of tidal volume (V(T)) and defined as the part of the tidal breath meeting the boundary of the MFVL, were measured. Higher FVC and maximal expiratory flows were found in Tr than UT (P < 0.05) at rest. Our results have shown that during exercise, excepting one subject, all Tr regulated their V(T) within FVC similarly during exercise, by breathing at low lung volume at the beginning of exercise followed breathing at high lung volume at strenuous exercise. In UT, ERV/FVC and IRV/FVC were regulated during exercise in many ways. The proportion of children who presented an expFL was nearly the same in both groups (approximately 70% with a range of 14 to 65% of V(T)), and no significant difference was found during exercise concerning expFL. However, higher ventilation (V(E)), ERV/FVC, and dyspnea associated with lower BR, IRV/FVC, and SaO2 were reported at peak power in Tr than UT (P < 0.05). These results suggest that, because of their higher Ve level, trained children presented higher ventilatory constraints than untrained. These may influence negatively the SaO2 level and dyspnea during strenuous exercise.     

肺通气功能程度与慢性阻塞性肺疾病患者夜间低氧发生的相关性分析

目的:研究肺通气功能程度与慢性阻塞性肺疾病患者夜间低氧发生的相关性。方法:选取2012年1月至2013年6月我院治疗的60例稳定期慢性阻塞性肺疾病患者,按肺通气功能分为轻度、中度、重度、极重度4组,每组15例,监测记录研究对象肺通气功能指标及夜间血氧指标,比较各组监测指标的差异,并分析其相关性。结果:不同病情程度COPD患者FEV1/FVC、FEV1、FVC、PEF、RV、RV/TLC、MsaO2、ODI、WsaO2、LsaO2、SIT90%有差异(P0.05);极重度和重度比较FEV1/FVC、FEV1、RV、MsaO2、ODI、WsaO2、LsaO2、SIT90%有差异(P0.05);极重度和中度比较FEV1/FVC、FEV1、FVC、PEF、RV、RV/TLC、MsaO2、ODI、WsaO2、LsaO2、SIT90%有差异(P0.05);极重度和轻度比较FEV1/FVC、FEV1、FVC、PEF、RV、RV/TLC、MsaO2、ODI、WsaO2、LsaO2、SIT90%有差异(P0.05);重度和中度比较FEV1/FVC、FEV1、FVC、PEF、RV/TLC、MsaO2有差异(P0.05);重度和轻度比较FEV1/FVC、FEV1、FVC、PEF、RV/TLC、MsaO2、ODI、LsaO2有差异(P0.05);中度和轻度比较FEV1/FVC、FEV1、FVC、PEF、ODI有差异(P0.05)。COPD患者的肺通气功能FEV1与MsaO2呈正相关(r=0.683,P0.05)。结论:肺通气功能程度与慢性阻塞性肺疾病患者夜间低氧发生具有相关性。     

Circadian rhythm of ventilatory parameters of intrinsic asthma in clinical remission

In six subjects with intrinsic asthma in clinical remission, time-structure of ventilatory parameters has been evaluated in order to evaluate: 1) which indexes present statistically significant circadian fluctuations; 2) if phase-shifts occur in comparison with normal subjects. After a period of synchronization of 7 days (L/D: 07.30-23.00; meal timing at 08.00, 13.00 and 20.30) all subjects have been studied by spirometry, flow-volume loop and Raw determination 6 times in a 24-hr period at constant intervals of 4 hrs. The results have been evaluated by macroscopic and microscopic analysis statistical significant fluctuations have been shown in these functional indexes: MEF50, Raw, SRaw, SGaw, FRC and RV; no phase-shifts occurred in comparison with normal subjects. On the contrary a circadian rhythm has not been shown in FVC, FEV1, and PEF. Therefore only the effort-independent test should be used to study correctly the bronchial tone.     

肺炎支原体抗体阳性对咳嗽变异性哮喘患儿肺功能的影响

目的探索肺炎支原体（Mycoplasma pneumoniae,MP）抗体阳性对咳嗽变异性哮喘（cough variant asthmaCVA）患儿肺功能的影响。方法收集72例初次诊断CVA的患儿,根据血清MP抗体结果分为CVA合并MP抗体阳性（以下记CVA合并MP）组,CVA组。分别对两组进行支原体抗体及肺功能检测。结果纳入本研究的CVA患儿,MP抗体阳性占29％,且这部分患儿中女孩比男孩多。CVA患儿肺功能FVC、FEV1／FVC、PEF、MMEF75／25各项指标均下降（P〈0．05）,合并MP组FVC、FEV1／FVC、PEF值变化差异无统计学意义（P〉0．05）,而MMEF75／25下降差异有统计学意义（P〈0．05）;CVA合并MP组支气管激发试验以极轻度、轻度为主（P〈0．05）,而CVA组以中重度为主（P〈0．05）;CVA合并MP组,在治疗一个月时FEV1％升高,差异有统计学意义（P〈0．05）;治疗相同时间两组间FEV1％差异无统计学差异（P〉0．05）。结论呼吸道的多种微生物间形成复杂而又互相联系的群落,MP使气道黏膜受到损害,影响呼吸系统局部微生态,这与哮喘的形成有某种联系。MP抗体阳性的CVA患儿气道高反应性较低,相比之下,小气道阻塞加重,且其对CVA治疗过程中肺通气功能的变化没有影响。     

肺炎支原体肺炎患儿外周血白介素的表达与肺功能变化的相关性

目的:探讨肺炎支原体(MPP)肺炎患儿外周血中IL-10、IL-17的表达水平与肺功能变化的相关性。方法:选取70例肺炎支原体肺炎患儿为研究对象,以是否有哮鸣音分为喘息组和非喘息组,以30例健康儿童为对照组,空腹采血5ml,分离血清,ELISA检测血清中IL-10、IL-17的表达水平,肺功能检测仪检测受检者的第一秒用力呼气容积(PEV1),最大呼气流量(PEF),用力肺活量(FEV1/FVC)。结果:喘息组中IL-10的表达水平与对照组相比差异显著(P0.05),喘息组中IL-10的表达水平与非喘息组相比差异显著(P0.05),喘息组中IL-17的表达水平与对照组相比差异显著(P0.05),喘息组中IL-17的表达水平与非喘息组相比差异显著(P0.05)。喘息组和非喘息组中IL-10水平均低于对照组,喘息组和非喘息组中IL-17水平均高于于对照组。非喘息组较喘息组PEV1、PEF、PVE1/FVC值高,差异显著(P0.05)。肺炎支原体肺炎患儿血清中的IL-10的水平与PEV1、PEF、PVE1/FVC呈正相关,肺炎支原体肺炎患儿血清中的IL-17的水平与PEV1、PEF、PVE1/FVC呈负相关。结论:肺炎支原体肺炎患儿血清中IL-10、IL-17的表达水平与肺功能密切相关。     

Occurrence of early and late asthmatic reaction after provocation with antigen and the status of pulmonary ventilation in patients with hay fever after the pollination season]

Pulmonary ventilation and asthmatic reaction under laboratory conditions have been investigated in 23 patients with allergic rhinitis hypersensitive to grass pollen. Pulmonary ventilation has been assessed with the aid of VCin, FVC, FEV1, FEV1/VCin, PEF, MEF50, and MTT. Asthmatic reaction has been produced by an inhalation of allergens mixture with dose-response technique. An early reaction has been diagnosed, when FEV1 decreased by at least 20% or MEF50 by 30% within 10 minutes, and late reaction when the same parameters decreased after 6 or 24 hours. An early asthmatic reaction has been noted in 2 patients (8.7%), late--in 4 patients (17.4%), and double (both early and late) reaction in 2 patients (8.7%). Pulmonary ventilation has been normal in all examined patients, except two of them with peripheral airways obstruction (MEF50 less than 70% of the normal value). Results suggest, that asthmatic reaction may be provoked in the laboratory in patients with pollinosis and normal pulmonary ventilation after pollen season. Such a reaction may also be expected during a natural exposition to pollens.     

Influence of passive smoking on basic anthropometric characteristics and respiratory function in young athletes

The primary objective of this study is to investigate the maintenance difference in basic anthropometric characteristics and to outline the dynamics of respiratory function change in youngsters athletes exposed to passive smoking (PS) and athletes not exposed to passive smoking in their families (NPS). High and weight were determined as basis anthropometric characteristics. Measured parameters for respiratory function were vital capacity (VC), forced expiratory volume in the first second (FEV1), maximum expiratory flow (PEF), forced expiratory flow at 50% forced vital capacity (MEF 50) and forced expiratory flow at 25% forced vital capacity (MEF 25). Significant statistical differences in separate spirometric variable were found in three variables (FEV1, MEF50, and MEF25) for group older youngsters. Analysis of variance showed statistical differences between athletes unexposed to passive smoking (NPS) and athletes exposed to passive smoking (PS) in even four spirometric variables (VC, FEV1, MEF50 and MEF25).     

大剂量乙酰半胱氨酸对高龄患者慢性阻塞性肺病合并肺间质纤维化急性加重期的干预作用及机制初探

目的：观察大剂量乙酰半胱氨酸（NAC）对高龄患者慢性阻塞性肺病（COPD）合并肺问质纤维化（PIF）急性加重期的干预作用,并对干预机制进行初步探讨。方法：年龄大于80岁COPD合并PIF患者18例,分为对照组（8例）和观察组（10例）,对照组给予常规治疗,观察组在对照组治疗基础上给予口服乙酰半胱氨酸颗粒600mg／次,3次／d,连用30天,观察两组治疗前后临床症状、肺功能指标（FVC、FEV1、FEV1／FVC）、动脉血氧分压（PaO2）、血液中细胞因子（IL-2和TNF—α）和影像学的变化。结果：观察组治疗总有效率和细菌培养转阴率显著升高（P〈0．05）;两组治疗后FVC、FEV1、FEV1／FVC、PaO2均较治疗前显著上升（P〈0．05）,血液中IL-2和TNF—α较治疗前显著下降（P〈0．05）;组间比较存在显著性差异（P〈0．05）;观察组治疗后胸部CT见感染明显控制。结论：在常规治疗基础上合用大剂量NAC可以有效治疗急性加重期COPD合并PIF的老年患者,机制可能与抑制炎性因子表达、减少细菌在呼吸道内的附着有关。     

Relationship between quasi-static pulmonary hysteresis and maximal airway narrowing in humans.

Two groups of subjects were studied: one with (group 1: 5 healthy and 4 mildly asthmatic subjects) and another without (group 2:9 moderately and severely asthmatic subjects) a plateau of response to methacholine (MCh). We determined the effect of deep inhalation by comparing expiratory flows at 40% of forced vital capacity from maximal and partial flow-volume curves (MEF40M/P) and the quasi-static transpulmonary pressure-volume (Ptp-V) area. In group 1, MEF40M/P increased from 1.58 +/- 0.23 (SE) at baseline up to a maximum of 3.91 +/- 0.69 after MCh when forced expiratory volume in 1 s (FEV1) was decreased on plateau by 24 +/- 2%. The plateau of FEV1 was always paralleled by a plateau of MEF40M/P. In group 2, MEF40 M/P increased from 1.58 +/- 0.10 at baseline up to a maximum of 3.48 +/- 0.26 after MCh when FEV1 was decreased by 31 +/- 3% and then decreased to 2.42 +/- 0.24 when FEV1 was decreased by 46 +/- 2%. Ptp-V area was similar in the two groups at baseline yet was increased by 122 +/- 9% in group 2 and unchanged in group 1 at MCh end point. These findings suggest that the increased maximal response to MCh in asthmatic subjects is associated with an involvement of the lung periphery.     

普米克都保联合沙丁胺醇对咳嗽变异性哮喘患儿的疗效分析

目的:探讨普米克都保联合沙丁胺醇对咳嗽变异性哮喘(CVA)患儿的疗效分析。方法:选取100例CVA患者,沙丁胺醇组(48例)给予沙丁胺醇联合用药组(52例)给予沙丁胺醇和普米克都保,观察并记录两组患者治疗后的疗效,咳嗽缓解及消失时间,治疗前后的用力肺活量(FVC),第1秒用力呼气容积(FEV1)、呼气峰流速(PEF)及最大呼气中段流速(MMEF)等肺功能指标及随访1个月期间的不良反应,评价普米克都保联合沙丁胺醇对咳嗽变异性哮喘的疗效。结果:治疗后联合用药组有效率明显高于沙丁胺醇组(P0.05),联合用药组中有92.3%患者,沙丁胺醇组有72.9%患者咳嗽症状在2周内消失,治疗后联合用药组咳嗽缓解时间和消失时间明显短于沙丁胺醇组(P0.05)。治疗前后,两组在FVC,FEVl,PEF上相比,差异没有统计学意义(P0.05),治疗前,两组MMEF水平均明显低于体检健康者(P0.05),其他肺功能指标与体检健康者相比,无统计学差异(P0.05)。治疗后联合用药组MMEF明显高于治疗前,且高于沙丁胺醇组(P0.05)。沙丁胺醇组治疗前后MMEF未出现明显变化(P0.05)。随访1个月期间,两组不良反应率相比,差异没有统计学意义(P0.05)。结论:普米克都保联合沙丁胺醇能对CVA具有较好的治疗作用,能缩短咳嗽症状消失时间,改善患儿肺功能,值得临床推广使用。     

肺炎支原体肺炎伴喘息儿童血清25(OH)D_3、Th17/Treg表达水平与肺功能的关系

目的:探讨肺炎支原体肺炎伴喘息儿童血清25羟基维生素D3[25(OH)D_3]、辅助性17细胞/调节性T细胞(Th17/Treg)表达水平与肺功能的关系。方法:将新疆医科大学第五附属医院收治的肺炎支原体肺炎伴喘息患儿26例作为肺炎伴喘息组,肺炎支原体肺炎不伴有喘息患儿54例作为肺炎不伴喘息组,另选取健康儿童30例作为对照组,比较各组血清25(OH)D_3、白细胞介素(IL)-10、IL-17、Th17细胞及Treg细胞占CD4+T细胞比例及肺功能,并分析其相关性。结果:肺炎伴喘息组血清25(OH)D_3、IL-10、Treg细胞占CD4+T细胞比例低于肺炎不伴喘息组、对照组,Th17细胞占CD4+T细胞比例、Th17/Treg、IL-17高于肺炎不伴喘息组、对照组(P0.05)。各组第一秒最大呼气量占用力肺活量百分比(FEV1/FVC)比较差异无统计学意义(P0.05),肺炎伴喘息组FEV1占预计值百分比(FEV1%pred)、峰值呼气流量(PEF)低于肺炎不伴喘息组、对照组(P0.05),肺炎不伴喘息组与对照组FEV1%pred、PEF比较无统计学意义(P0.05)。肺炎伴喘息组患儿血清25 (OH)D_3与Th17/Treg、IL-17呈负相关(P0.05),与IL-10、FEV1%pred、PEF呈正相关(P0.05),血清Th17/Treg与IL-10、FEV1%pred、PEF呈负相关(P0.05),与IL-17呈正相关(P0.05)。结论:肺炎支原体肺炎伴喘息儿童血清25(OH)D_3、Th17/Treg表达水平异常,肺功能下降,且25(OH)D_3、Th17/Treg表达水平与肺功能相关。     

顺铂联合立体定向体部放疗治疗晚期肺癌的疗效及对患者血清CYFRA21-1、DR70和肺功能的影响

目的:研究顺铂联合立体定向体部放疗治疗晚期肺癌的疗效及对患者血清角质蛋白21-1(CYFRA21-1)、DR70和肺功能的影响。方法:选择2016年2月到2018年2月在我院诊治的晚期肺癌患者110例,并根据随机数表法将其分为观察组(n=58)和对照组(n=52)。对照组使用常规化疗,观察组采用顺铂联合立体定向体部放疗。比较两组治疗后的疗效、治疗前后血清CYFRA21-1、DR70、第一秒最大呼气量(FEV1)、一秒用力呼气容积/用力肺活量(FEV1/FVC)、最大呼气流速峰值(PEF)及生活质量评分的变化。结果:治疗后,两组患者总有效率分别为86.21%、59.62%,观察组显著高于对照组(P0.05);两组血清CYFRA21-1、DR70水平较治疗前均显著降低(P0.05),且观察组以上指标明显低于对照组(P0.05);两组FEV1、FEV1/FVC、PEF较治疗前均显著升高(P0.05),且观察组以上指标均明显高于对照组(P0.05);两组患者生活质量各项评分均较治疗前明显升高,且观察组患者生活质量各项评分均显著高于对照组(P0.05)。结论:顺铂联合立体定向体部放疗治疗晚期肺癌的临床疗效显著优于单用常规化疗,其可有效改善患者血清CYFRA21-1、DR70水平和肺功能。     

Pioglitazone is as effective as dexamethasone in a cockroach allergen-induced murine model of asthma

Background

The aims of this study were to verify the feasibility of respiratory function tests and to assess their validity in the diagnosis of respiratory disorders in young children.

Methods

We performed spirometry and collected information on health and parents' lifestyle on a sample of 960 children aged 3–6.

Results

The cooperation rate was 95.3%. Among the valid tests, 3 or more acceptable curves were present in 93% of cases. The variability was 5% within subjects in 90.8% of cases in all the parameters. We propose regression equations for FVC (Forced Vital Capacity), FEV1, FEV0.5, FEV0.75 (Forced Expiratory Volume in one second, in half a second and in 3/4 of a second), and for Maximum Expiratory Flows at different lung volume levels (MEF75, 50, 25). All parameters are consistent with the main reference values reported in literature. The discriminating ability of respiratory parameters versus symptoms always shows a high specificity (>95%) and a low sensitivity (<20%) with the highest OR (10.55; IC95% 4.42–25.19) for MEF75. The ability of FEV0.75 to predict FEV1 was higher than that of FEV0.50: FEV0.75 predicts FEV1 with a determination coefficient of 0.95.

Conclusion

Our study confirms the feasibility of spirometry in young children; however some of the current standards are not well suited to this age group. Moreover, in this restricted age group the various reference values have similar behaviour.     

Effect of 16 weeks diving practice at two different times of day on the pulmonary function,spirometry measurements and 6-minute walk test data of healthy professional Tunisian scuba divers

The aim of this study was to investigate the effect of time of the day (TOD) and 16 weeks diving practice (16WDP) on the spirometric parameters and 6-min walk test data (6MWT) on professional Tunisian scuba divers. In randomized order, 36 health males divided into 3 groups [morning practice group) (MPG): n = 12; evening practice group (EPG): n = 12; control group (CG) n = 12] participated voluntary in this study. They performed spirometry measurements and 6MWT during two periods: [before-season (June 05–10), and after-season (October 05–10)]. Our results revealed that assessment sessions comprised the following: FVC, FEV1, FEV1/FVC and PEF. Results were analyzed by applying repeated measures analysis of variance ANOVA. The spirometric parameters were similar upon two times of day on both EPG and MPG before the season (i.e. FEV1, FVC). Likewise, our finding revealed a significant decrease in lung functions following the 16 weeks practice of scuba diving upon two times of day. Thus, this period of hyperbaric scuba diving practice lead a significant alteration of lung function parameters with decrease of percent of variation in EPG vs. CEG compared to MPG vs. CMG: (i.e. FEV1, FVC, and PEF). In conclusion, 16 weeks of hyperbaric scuba diving lead a significant change in the spirometric and 6MWT values and respiratory problem with damage on lung function in healthy adult divers older than 40 years. Professional divers are recommended to have practice diving in the morning.     

Lung mechanics in individuals with spinal cord injury: effects of injury level and posture.

Individuals with spinal cord injury (SCI) exhibit reduced lung volumes and flow rates as a result of respiratory muscle weakness. These features have not, however, been investigated in relation to the combined effects of injury level and posture. Changes in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)), FEV(1)/FVC, forced expiratory flow at 50% vital capacity (FEF(50)), inspiratory capacity (IC), and expiratory reserve volume (ERV) were assessed by injury level in the seated and supine positions in 74 individuals with SCI. The main findings were 1) FVC, FEV(1), and IC increased with descending SCI level down to T(10), below which they tended to level off; 2) supine values of FVC and FEV(1) tended to be larger in the supine compared with the seated posture down to injury level T(1), caudad to which they were less than when seated; 3) IC increased proportionately more down to injury level L(1), below which it declined slightly and plateaued; 4) ERV was measurable even at high cervical injuries, was generally smaller in the supine position, reached peak values in both positions at T(10) injury level, and then rapidly declined at lower levels; 5) when subjects were separated according to current, former, and never smokers, only formerly smoking paraplegic individuals demonstrated spirometric values significantly less than paraplegic individuals who never smoked. Changes in spirometric measurements in SCI are dependent on injury level and posture. These findings support the concept that the increase in vital capacity in supine position is related to the effect of gravity on abdominal contents and increase in IC.     

硝黄散外敷联合加味五虎汤口服治疗痰热闭肺型肺炎支原体肺炎患儿对肺功能和血清TNF-α、IFN-γ、IL-4水平的影响

目的:观察硝黄散外敷联合加味五虎汤口服治疗痰热闭肺型肺炎支原体肺炎(MPP)患儿对肺功能和血清肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)、白介素-4(IL-4)水平的影响。方法:研究对象为我院2019年6月~2021年1月期间收治的MPP患儿80例,采用随机数字表法将患儿分为对照组(n=40,阿奇霉素抗感染治疗)和研究组(n=40,对照组基础上加用硝黄散外敷联合加味五虎汤口服治疗),均治疗7 d。比较两组患儿临床疗效,比较两组治疗前、治疗7 d后的中医证候积分、临床症状改善情况、肺功能和血清TNF-α、IFN-γ、IL-4水平。结果:研究组治疗7 d后的临床总有效率为92.50%(37/40),高于对照组的72.50%(29/40),差异有统计学意义(P<0.05)。与对照组相比,研究组的症状(咳嗽憋喘、发热、肺部干湿啰音)消失时间均更短(P<0.05)。与对照组相比,研究组治疗7 d后用力肺活量(FVC)、最高呼气峰流速(PEF)、第1秒最大呼气容积(FEV1)、FEV1/FVC均更高(P<0.05),研究组治疗7 d后的中医证候积分及血清TNF-α、IFN-γ和IL-4水平均更低(P<0.05)。结论:痰热闭肺型MPP患儿采用硝黄散外敷联合加味五虎汤口服治疗,可有效缩短患儿症状消失时间,显著改善其肺功能、血清炎症因子水平,疗效显著。     

Relation between fat mass, fat free mass and ventilatory function in children and adolescents

The aim of the present study was to evaluate the relation between fat mass (FM), fat free mass (FFM) and ventilatory function in children and adolescents. 1 174 healthy children and adolescents (583 males and 591 females) aged 10-18 years were selected from Heilongjiang Province through random sampling by means of questionnaire and physical examination, and measured for height, weight, waist to hip ratio (WHR), FM, FFM and ventilatory function. The data were analyzed by means of independent-samples t test, Pearson correlation analysis and multi-factors regression analysis. Regardless of sex, an independent positive correlation was found (P<0.001) between age and FFM index (FFMI). FM index (FMI) correlated negatively with age in males (P<0.001), but positively with age in females (P<0.001). Regardless of sex, FFMI correlated positively with forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow at 25% of forced vital capacity (FEF25%), FEF50%, and maximal mid-expiratory flow (MMEF) (P<0.05), while negatively with FEV1/FVC (P<0.01). FFMI was correlated positively with FEF75% in males (P<0.05), but not correlated in females. In males, FMI correlated negatively with FEV1, FEV1/FVC, PEF, FEF25%, FEF50%, FEF75% and MMEF (P<0.05), but not correlated with FVC. No correlation was found between the ventilatory function indices and FMI in females. Except FEV1/FVC and FEF75% in males, the effect of FFMI in predicting ventilatory function was higher than FMI regardless of sex. Moreover, the predicting effect of FFMI was higher in males than that in females. Growth spurt of lung function occurred in the ages of 12-15 years in males, while in the ages of 12, 13 and 18 years in females. During the period of growth spurt of lung function, regardless of sex, the effect of FFMI in predicting the lung function was higher than that of age. In conclusion, regardless of sex, FFMI correlates positively with ventilatory function, as a reflection of muscle mass. The effect of FFM in predicting ventilatory function is higher in males than that in females. FM correlates negatively with ventilatory function in males, but not in females. The rapid growth of height and FFM are possibly the main reasons for growth spurt of lung function.     

布地奈德和沙丁胺醇雾化吸入对小儿支气管肺炎的治疗效果

为了探讨布地奈德和沙丁胺醇雾化吸入对小儿支气管肺炎的治疗效果,本研究选取138例小儿支气管肺炎患儿随机分组,对照组患儿应用布地奈德治疗,试验组患儿给予布地奈德联合沙丁胺醇治疗,观察比较两组患儿TGF-β1、CRP水平、肺功能水平、临床症状消失时间差异。研究结果表明,治疗后试验组患儿TGF-β1 (1.50±0.46)μg/mL、CRP (12.01±0.97)μg/mL较对照组明显下降(p<0.05);治疗后试验组患儿FEV1(2.68±0.86) L、FEV1/FVC (85.67±8.65)%、PEF变异率(12.04±1.59)%较对照组比较明显改善(p<0.05);试验组患儿咳嗽持续时间(4.49±0.35) d、啰音持续时间(5.79±0.51) d、发热持续时间(2.18±0.24) d、肺部X线阴影持续时间(6.16±0.63) d同对照组比较明显缩短(p<0.05)。本研究初步表明,针对小儿支气管肺炎患儿应用布地奈德和沙丁胺醇雾化吸入治疗可有效改善临床症状和通气功能,改善临床指标,促进患儿康复,值得推广应用。     

Bach1与Nrf2调控γ-谷氨酰半胱氨酸合成酶对大鼠慢性阻塞性肺疾病的作用

为了探讨Bach1 (BTB and CNC homology 1)与红系衍生的核因子相关因子2（Nrf2）和γ-谷氨酰半胱氨酸合成酶（γ-GCS）的表达变化在慢性阻塞性肺疾病（COPD）中的作用和意义,用气管内注入脂多糖及熏香烟的复合刺激法建立大鼠COPD 模型．观察两组大鼠的肺组织病理学改变,测两组大鼠的肺功能指标;应用免疫组化、Western印迹、原位杂交和逆转录 聚合酶链反应（RT-PCR）等方法检测Bach1与Nrf2及γ GCS 在两组大鼠的肺组织中的表达．结果显示,COPD组的肺功能指标（FEV_0.3、FEV_0.3/FVC%、PEF）明显恶化;光镜下肺组织病理改变符合COPD的特征性改变;γ GCS与Nrf2 的mRNA及蛋白质表达在COPD组大鼠肺组织中明显增强;而Bach1 mRNA及蛋白质在COPD组和对照组的表达无明显差别．且核/胞浆分离技术表明,Nrf2蛋白在对照组主要表达于胞浆,胞核中表达水平较弱,在COPD组胞浆、胞核均有表达,但是在胞核中的水平明显升高;Bach1蛋白在对照组主要表达于胞核中,胞浆中无明显表达,在COPD组主要表达于胞浆,胞核中无明显表达．相关性分析表明,γ-GCS mRNA与FEV_0.3、FEV_0.3/FVC%、PEF均呈负相关;Nrf2蛋白表达与γ GCS mRNA呈正相关;Bach1蛋白与γ GCS mRNA呈负相关．上述结果提示,Bach1与Nrf2和γ-GCS可能均在大鼠COPD的发病中发挥作用,且Bach1和Nrf2可能通过竞争性机制调控γ-GCS的表达,影响COPD的发生和发展．     

哮喘患儿呼出气一氧化氮、1,25-二羟维生素D3及儿童哮喘控制测试评分与肺功能的相关性

目的:探讨哮喘患儿呼出气一氧化氮(FeNO)、1,25-二羟维生素D_3[1,25(OH)_2D_3]及儿童哮喘控制测试(C-ACT)评分与肺功能的相关性。方法:选取2017年6月～2018年6月在我院就诊的86例哮喘患儿作为观察组,另选取同期于我院进行健康检查的86例健康儿童作为对照组。比较两组受试儿童1,25(OH)_2D_3浓度、FeNO、一秒用力呼气容积(FEV1)、呼气流量峰值(PEF)水平,比较不同病情哮喘患儿1,25(OH)_2D_3浓度、FeNO、C-ACT、FEV1、PEF水平,并分析哮喘患儿1,25(OH)_2D_3、FeNO、C-ACT与肺功能的相关性。结果:观察组1,25(OH)_2D_3浓度、FEV1、PEF水平低于对照组(P0.05),FeNO水平高于对照组(P0.05);随着病情加重,1,25(OH)_2D_3浓度、PEF、FEV1水平、C-ACT评分均逐渐下降,FeNO水平逐渐升高,不同病情患儿间比较差异均有统计学意义(P0.05)。哮喘患儿1,25(OH)_2D_3与FEV1、PEF呈正相关(r=0.912、0.873,P=0.006、0.008);C-ACT与FEV1、PEF呈正相关(r=0.472、0.366,P=0.036、0.032);FeNO与FEV1、PEF无相关(r=-0.035、-0.124,P=0.075、0.064)。结论:哮喘患儿1,25(OH)_2D_3浓度、C-ACT评分明显降低,FeNO水平明显升高,1,25(OH)_2D_3、C-ACT评分与肺功能呈正相关,但FeNO与肺功能无相关,C-ACT可用于哮喘患儿病情的预测,同时,通过提高患儿体内1,25(OH)_2D_3浓度可以改善其肺功能。