The role of small airway function parameters in preschool asthmatic children

作者全名："Yi, Liangqin; Zhao, Yan; Guo, Ziyao; Li, Qinyuan; Zhang, Guangli; Tian, Xiaoyin; Xu, Ximing; Luo, Zhengxiu"

作者地址："[Yi, Liangqin; Zhao, Yan; Guo, Ziyao; Li, Qinyuan] Univ Educ, Chongqing Key Lab Pediat, Int Sci & Technol Cooperat Base Child Dev & Crit D, Dept Childrens Hosp Chongqing Med,Key Lab Child De, Chongqing 400014, Peoples R China; [Zhang, Guangli; Tian, Xiaoyin; Luo, Zhengxiu] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Resp Med, Childrens Hosp, Chongqing, Peoples R China; [Xu, Ximing] Chongqing Med Univ, Big Data Ctr Childrens Med Care, Childrens Hosp, Chongqing, Peoples R China"

通信作者："Luo, ZX (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Resp Med, Childrens Hosp, Chongqing, Peoples R China."

来源：BMC PULMONARY MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001009860200003

JCR分区：Q2

影响因子：2.6

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Asthma; Small airway function; Spirometry; FEF25-75%; FEF50%; FEF75%

摘要："BackgroundSmall airways are the major sites of inflammation and airway remodeling in all severities of asthma patients. However, whether small airway function parameters could reflect the airway dysfunction feature in preschool asthmatic children remain unclear. We aim to investigate the role of small airway function parameters in evaluating airway dysfunction, airflow limitation and airway hyperresponsiveness (AHR).MethodsEight hundred and fifty-one preschool children diagnosed with asthma were enrolled retrospectively to investigate the characteristics of small airway function parameters. Curve estimation analysis was applied to clarify the correlation between small and large airway dysfunction. Spearman's correlation and receiver-operating characteristic (ROC) curves were employed to evaluate the relationship between small airway dysfunction (SAD) and AHR.ResultsThe prevalence of SAD was 19.5% (166 of 851) in this cross-sectional cohort study. Small airway function parameters (FEF25-75%, FEF50%, FEF75%) showed strong correlations with FEV1% (r = 0.670, 0.658, 0.609, p<0.001, respectively), FEV1/FVC% (r = 0.812, 0.751, 0.871, p<0.001, respectively) and PEF% (r = 0.626, 0.635, 0.530, p<0.01, respectively). Moreover, small airway function parameters and large airway function parameters (FEV1%, FEV1/FVC%, PEF%) were curve-associated rather than linear-related (p<0.001). FEF25-75%, FEF50%, FEF75% and FEV1% demonstrated a positive correlation with PC20 (r = 0.282, 0.291, 0.251, 0.224, p<0.001, respectively). Interestingly, FEF25-75% and FEF50% exhibited a higher correlation coefficient with PC20 than FEV1% (0.282 vs. 0.224, p = 0.031 and 0.291 vs. 0.224, p = 0.014, respectively). ROC curve analysis for predicting moderate to severe AHR showed that the area under the curve (AUC) was 0.796, 0.783, 0.738, and 0.802 for FEF25-75%, FEF50%, FEF75%, and the combination of FEF25-75% and FEF75%, respectively. When Compared to children with normal lung function, patients with SAD were slightly older, more likely to have a family history of asthma and airflow obstruction with lower FEV1% and FEV1/FVC%, lower PEF% and more severe AHR with lower PC20 ( all p<0.05).ConclusionSmall airway dysfunction is highly correlated with large airway function impairment, severe airflow obstruction and AHR in preschool asthmatic children. Small airway function parameters should be utilized in the management of preschool asthma."

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