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一家三级政府医院中杜氏肌营养不良症儿科患者的临床概况及肺功能

Clinical Profile and Pulmonary Function of Pediatric Patients with Duchenne Muscular Dystrophy at a Tertiary Government Hospital.

作者信息

Arquillo Maria L, Layug Elbert John V, Lozada Maria Cristina H, Bautista Kevin L, Calotes-Castillo Loudella

机构信息

Division of Pediatric Pulmonology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila.

Division of Pediatric Neurology, Department of Pediatrics and Neurosciences, Philippine General Hospital, University of the Philippines Manila.

出版信息

Acta Med Philipp. 2024 Nov 29;58(21):49-59. doi: 10.47895/amp.vi0.7975. eCollection 2024.

Abstract

OBJECTIVE

Our study aimed to determine the clinical profile and pulmonary function of pediatric patients with Duchenne Muscular Dystrophy (DMD). We also characterized the stages of progression of the disease and determined their potential association with spirometry variables.

METHODS

In this cross-sectional study, we used data obtained from a review of medical records of all pediatric patients (0-18 years old) with DMD seen in a multidisciplinary neuromuscular clinic of a tertiary government hospital from August 2018 until March 2020.

RESULTS

Included were 30 patients subdivided into groups according to the stage of disease progression. Overweight (26.7%), obesity (20%), and scoliosis (26.7%) were common among non-ambulatory patients. Only one late ambulatory patient had evidence of ineffective airway clearance. Symptoms of sleep-disordered breathing, particularly snoring (66.7%) and apnea (6.7%), were common across all disease stages. All patients had normal peripheral oxygen saturation on room air. The mean peak expiratory flow rate was 215.6 (±84) L/min. The mean Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), and FEV1/FVC were 66.2% (±23.7), 67.7% (±23.8), and 97.5 (±3.2), respectively. Among patients with polysomnography results, the average apnea-hypopnea index (AHI) per hour was 3 (±1.6). When patients were compared according to their stage disease progression, however, no significant differences exist.

CONCLUSION

This is the first study on the pulmonary function of Filipino pediatric patients with DMD. Spirometry patterns characteristic of restrictive lung disease were observed. Prospective studies may help identify respiratory variables that significantly correlate with pulmonary function.

摘要

目的

我们的研究旨在确定杜氏肌营养不良症(DMD)儿科患者的临床特征和肺功能。我们还对疾病进展阶段进行了特征描述,并确定了它们与肺量计变量的潜在关联。

方法

在这项横断面研究中,我们使用了从2018年8月至2020年3月在一家三级政府医院的多学科神经肌肉诊所就诊的所有DMD儿科患者(0至18岁)的病历回顾中获得的数据。

结果

纳入了30名患者,根据疾病进展阶段进行分组。超重(26.7%)、肥胖(20%)和脊柱侧弯(26.7%)在非行走患者中很常见。只有一名晚期行走患者有气道清除无效的证据。睡眠呼吸障碍症状,特别是打鼾(66.7%)和呼吸暂停(6.7%),在所有疾病阶段都很常见。所有患者在室内空气中的外周血氧饱和度均正常。平均呼气峰值流速为215.6(±84)升/分钟。平均用力肺活量(FVC)、第一秒用力呼气量(FEV1)和FEV1/FVC分别为66.2%(±23.7)、67.7%(±23.8)和97.5(±3.2)。在有多导睡眠图结果的患者中,每小时平均呼吸暂停低通气指数(AHI)为3(±1.6)。然而,根据疾病进展阶段对患者进行比较时,没有发现显著差异。

结论

这是第一项关于菲律宾DMD儿科患者肺功能的研究。观察到了限制性肺病特征性的肺量计模式。前瞻性研究可能有助于确定与肺功能显著相关的呼吸变量。

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