种族中立方程和肺功能测试解释在两个儿科队列
George Doumat1, Geneva D Mehta2, Janice A Espinola1
1Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA.
The Journal of pediatrics
|May 30, 2024
概括
新的种族中立肺功能方程增加了黑人儿童呼吸系统障碍的患病率和严重程度. 这些发现凸显了螺旋测量解释的差异,以及需要公平的儿科呼吸护理的需要.
科学领域:
- 儿科肺病学 儿科肺病学
- 呼吸系统药物 呼吸系统药物
- 卫生公平性健康公平性
背景情况:
- 螺旋测量解释传统上使用种族特定的方程.
- 最近向种族中立方程的转变旨在实现更大的公平.
- 这些新方程式对儿科肺功能预测的影响需要进行调查.
研究的目的:
- 评估儿童预测肺功能测量的变化,使用全球肺部倡议 (GLI) 新的种族中立方程.
- 为了比较以种族中立与种族特定的GLI方程解释的螺旋测量结果.
- 根据新的指导方针,评估种族与呼吸系统障碍患病率和严重程度的关联.
主要方法:
- 分析了来自两个健康儿童和有严重支气管炎病史的潜在多中心队列的数据.
- 分析了677名儿童在6年身体检查中的螺旋测量数据,使用新的GLI全球和2012年GLI方程.
- 多变量后勤回归,根据年龄,身高和性别进行调整,根据2022年美国胸部协会指南,检查了种族与新的或增加的呼吸功能障碍 (FEV1z-score ≤-1.645) 的关联.
主要成果:
- 种族中立方程增加了白人儿童预测的FEV1和FVC,但在黑人儿童中降低了它们.
- 在白人儿童中,阻塞的患病率增加了21%,在黑人儿童中,可能的限制增加了222%.
- 与白人种族相比,黑人种族与更高的呼吸系统损伤患病率 (aOR 7.59) 和严重程度 (aOR 35.40) 有关.
结论:
- 采用种族中立的螺旋计参考方程导致黑人儿童呼吸系统障碍的患病率和严重程度增加.
- 这些发现强调了在呼吸系统健康评估中解决种族差异的必要性.
- 这项研究支持将种族从螺旋测量解释中删除,因为缺乏生物学理由和观察到的不平等.
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