中国实用儿科杂志

中国实用儿科杂志

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儿童结缔组织病肺功能结果分析（附70例报告）

  

  1. 中国医科大学附属盛京医院小儿肾脏风湿科，辽宁 沈阳 110004
  • 出版日期:2020-05-06 发布日期:2020-05-18

Analysis of the results of pulmonary function tests in children with connective tissue disease：A report of 70 cases

  1. Department of Pediatrics，Shengjing Hospital of China Medical University，Shenyang 110004，China
  • Online:2020-05-06 Published:2020-05-18

摘要： 目的　评估结缔组织病（CTD）患儿肺功能状况，为进一步随访治疗提供依据。方法　收集2017年12月至2019年12月中国医科大学附属盛京医院小儿肾脏风湿科住院治疗的CTD患儿35例（CTD组），男10例，女25例。常规测定肺通气功能及一氧化碳弥散功能，并与年龄相匹配的健康对照组25例（男9例，女16例）进行比较。应用SPSS18.0统计软件对CTD组和对照组的肺功能数据进行统计学分析。结果　CTD组肺功能异常共19例（54.29%），其中肺通气功能障碍17例（48.57%）：分别为限制性通气功能障碍5例（14.29%），阻塞性通气功能障碍5例（14.29%），限制性和阻塞性混合通气功能障碍2例（5.71%），单纯小气道功能障碍5例（14.29%）；肺换气功能障碍8例（22.86%）：合并通气功能障碍（限制性或阻塞性或小气道）6例（17.14%），单纯弥散功能障碍2例（5.71%）。研究组肺功能参数VCmax、TLC、FVC、FEV1、FEV1/FVC、PEF、FEF50、FEF75、DLCOSB均明显低于对照组。结论　CTD患儿肺功能损害较为严重，限制性通气功能障碍与阻塞性通气功能障碍均常见，小气道功能障碍和弥散功能障碍可能是肺损害的早期阶段。临床医师对于CTD患儿应进行早期系统的肺功能检测。

关键词: 肺功能, 结缔组织病, 肺受累

Abstract: Objective　To assess pulmonary function status and provide evidence for treatment and follow-up in children with connective tissue disease（CTD）. Methods　A total of 35 children（10 boys，25 girls） treated in Department of Pediatrics，Shengjing Hospital of China Medical University between December 2017 and December 2019 were included in the study. Routine test was made in pulmonary ventilatory function and diffusing function of carbon monoxide，and compared with 25 age-matched healthy controls（9 boys，16 girls）. SPSS 18.0 software was used to analyze these data statistically. Results　A total of 19 cases（54.29%） of abnormal pulmonary function were in the study group. There were 17 cases（48.57%） of ventilatory defect. Restrictive ventilatory defect was in 5 cases（14.29%），obstructive ventilatory defect was in 5 cases（14.29%），restrictive and obstructive ventilatory defect was in 2 cases（5.71%），and pure small airways dysfunction was in 5 cases（14.29%）. Reduced diffusing lung capacity for carbon monoxide was in 8 cases（22.86%），in which 6 cases（17.14%） were combined with coexisted ventilatory or abnormal small airways flow，and 2 cases（5.71%）had decreased diffusing lung capacity. The parameters of pulmonary function tests（VCmax，TLC，FVC，FEV1，FEV1/FVC，PEF，FEF50，FEF75，DLCOSB） were significantly lower in CTD than in control group. Conclusion　Pulmonary function impairment is relatively severe in children with CTD. Restrictive and obstructive ventilatory defect are both common. Small airways flow limitation and decreased diffusing lung capacity for carbon monoxide maybe an early marker of lung involvement. CTD children require a prompt and systematic pulmonary function tests.

Key words: pulmonary function test, connective tissue disease, pulmonary involvement