期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 123, 期 4, 页码 861-867出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2008.10.036
关键词
Pediatric asthma; impulse oscillometry; spirometry; therapy of asthma
资金
- National Heart, Lung, and Blood Institute [U1OHL064287, 5U10HL064288, 5U10HL064295, 5U10HL064305, 5U10HL064307]
- National Jewish Medical and Research Center [M01 RR00051]
- Washington University School of Medicine [M01 RR00036]
- University of Wisconsin [MO1 RR03186]
Background: Determination of the benefits and limitations of specific physiologic tests has not been well studied in long-term clinical pediatric trials. Objective: We sought to determine the utility of impulse oscillometry in a long-term comparison of 3 controller regimens in children with persistent asthma. Methods: Children 6 to 14 years of age with mild-to-moderate persistent asthma were characterized with oscillometry and spirometry before entry into a clinical trial and then serially during 48 weeks of therapy with either an inhaled corticosteroid, a combination inhaled corticosteroid with a long-acting beta-agonist, or a leukotriene receptor antagonist. Results: The FEV1/forced vital capacity ratio, as well as the forced expiratory flow from 25% to 75% of forced vital capacity in terms of spirometric parameters and the reactance area (XA) from impulse oscillometry, appeared to complement information provided by FEV1 when comparing the tests and factors that appeared to predict a response to treatment. XA was unique in that it, as distinct from spirometric variables, reflected ongoing improvement during the latter part of the trial. In general, improvements in XA during the latter part of the study occurred independently of indices of atopy and the level of airway responsiveness. Conclusion: Assessment of respiratory mechanics over time with oscillometry might offer additional insights into the response of asthmatic patients to therapy. In particular, the pattern of improvement seen in XA over the course of therapy suggests this test might detect alterations in airway mechanics not reflected by spirometry. The possibility that changes in XA reflect ongoing improvement in small airway function deserves additional study. (J Allergy Clin Immunol 2009;123:861-7.)
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