幼児期における呼吸道機能の低下と22歳までに肺機能の低下:非選択的縦断コホート研究
Debra A Stern1, Wayne J Morgan, Anne L Wright
1Arizona Respiratory Center, University of Arizona, Tucson, Arizona, USA.
Lancet (London, England)
|September 4, 2007
まとめ
赤ちゃんの呼吸道機能は,出生直後に測定され,成人の肺機能を予測します. 早期の呼吸道機能の不良は,気流阻害の危険因子であり,慢性閉塞性肺疾患の予防は出生前に始まることを示唆しています.
科学分野:
- 呼吸器医学とは
- 小児肺病学について
- エピデミオロジー エピデミオロジー
背景:
- 成人初期における肺機能は,慢性閉塞性肺疾患 (COPD) の主要な予測因子である.
- 大人の肺機能に影響を及ぼす初期の人生の要因は,完全に理解されていません.
- 早期の呼吸道機能が後の肺の健康に与える影響を調査することは,COPDの予防に不可欠です.
研究 の 目的:
- 赤ちゃんの呼吸道機能が,出生直後に測定され,成人の初期に肺機能に影響するかどうかを判断する.
- 空気流の阻害の発達を予測するための生命の初期マーカーを特定する.
主な方法:
- 選択されていない乳児の長距離研究 (トゥクソン・チルドレン・レスピラトリー・スタディ,1980-1984).
- 幼児期 (平均2.3ヶ月) で測定された機能的残留容量 (Vmax (FRC)) での最大呼気流量.
- 肺機能 (FEV1,FVC,FEF25-75) は11歳,16歳,22歳の時に評価され,支支支管管拡張剤への反応があった.
主要な成果:
- Vmax (FRC) の最低四分位数の乳児は,22歳までFEV1/FVC比,FEF25-75,FEV1が著しく低かった.
- これらの関連性は,身長,体重,年齢,性別,喘息,喫煙,アトピー,および親の喘息を調整した後も依然として有意であった.
- この発見は,早期の呼吸道メカニズムと,後の閉塞性肺疾患の指標との間の持続的なリンクを強調しています.
結論:
- 幼児期における呼吸道機能の低下は,若い成人期における空気循環阻害を発症させる重要な危険因子である.
- これらの結果は,COPDを予防するための介入は胎児の発達中に開始する必要があることを示唆しています.
- 早期の呼吸器の健康は,長期的な肺機能と病気の予防に不可欠です.
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