CAJ | 학술논문

目的：比较小于胎龄儿（SGA）和适于胎龄儿（AGA）婴儿期肺功能的差异。方法2010年7月至2013年7月在深圳市儿童医院 NICU 住院的胎龄﹤36周、无明显影响肺功能疾病的 SGA 为 SGA 组；出生体重与 SGA 组匹配的 AGA 为AGA 组。两组均于纠正胎龄12月龄随访时行潮气呼吸和功能残气量检测，比较两组肺功能参数的差异。多元线性回归分析 SGA 组影响小气道功能的因素。结果 SGA 组20例（男12例，女8例），AGA 组30例（男17例，女13例）进入分析。两组在出生体重和身长，机械通气天数等基线数据差异无统计学意义（ P ﹥0.05）；SGA 组胎龄和用氧天数高于 AGA组，SGA 组随访时体重和身长均低于 AGA 组（P ﹤0.05）。①在纠正胎龄12月龄随访时两组呼吸频率、潮气量、每公斤潮气量、分钟通气量和功能残气量的差异均无统计学意义（P ﹥0.05）；呼气达峰时间、呼气达峰容积、呼气达峰时间比、呼气达峰容积比，75%、50%和25%潮气量时呼气流速，SGA 组均低于 AGA 组（P ﹤0.05）。②两组 NICU 出院至肺功能检测期间下呼吸道感染≥3次的比例，SGA 组为90%（18/20），AGA 组为50%（15/30），差异有统计学意义。③多元线性回归显示，SGA 组25%潮气量时呼气流速与检测肺功能随访时身长、体重呈正相关，与吸氧天数呈负相关。结论 SGA 婴儿期肺容积参数与出生体重相近的 AGA 相近，但气道阻力高于 AGA，可能与 SGA 生后肺发育迟缓相关。
목적：비교소우태령인（SGA）화괄우태령인（AGA）영인기폐공능적차이。방법2010년7월지2013년7월재심수시인동의원 NICU 주원적태령﹤36주、무명현영향폐공능질병적 SGA 위 SGA 조；출생체중여 SGA 조필배적 AGA 위AGA 조。량조균우규정태령12월령수방시행조기호흡화공능잔기량검측，비교량조폐공능삼수적차이。다원선성회귀분석 SGA 조영향소기도공능적인소。결과 SGA 조20례（남12례，녀8례），AGA 조30례（남17례，녀13례）진입분석。량조재출생체중화신장，궤계통기천수등기선수거차이무통계학의의（ P ﹥0.05）；SGA 조태령화용양천수고우 AGA조，SGA 조수방시체중화신장균저우 AGA 조（P ﹤0.05）。①재규정태령12월령수방시량조호흡빈솔、조기량、매공근조기량、분종통기량화공능잔기량적차이균무통계학의의（P ﹥0.05）；호기체봉시간、호기체봉용적、호기체봉시간비、호기체봉용적비，75%、50%화25%조기량시호기류속，SGA 조균저우 AGA 조（P ﹤0.05）。②량조 NICU 출원지폐공능검측기간하호흡도감염≥3차적비례，SGA 조위90%（18/20），AGA 조위50%（15/30），차이유통계학의의。③다원선성회귀현시，SGA 조25%조기량시호기류속여검측폐공능수방시신장、체중정정상관，여흡양천수정부상관。결론 SGA 영인기폐용적삼수여출생체중상근적 AGA 상근，단기도조력고우 AGA，가능여 SGA 생후폐발육지완상관。
Objective To compaer thr diffrerncrs in lung function brtwrrn small foe grstational agr infants( SGA)and appeopeiatr foe grstational agr infants( AGA). Methods Feom July 2010 to July 2013,hospitalizrd SGA infants in Shrnzhrn Childern's Hospital Nronatal Intrnsivr Caer Unit(NICU)wrer geouprd as SGA geoup,with grstational agr ﹤ 36 wrrks. SGA geoup had no disoedres with significant rffrct on lung function. AGA geoup was matchrd with thr grstational agr,bieth wright in asprcts of SGA geoup. Tidal berathing function was trstrd and functional ersidual capacity(FRC)was mrasuerd by multiplr berath washout mrasuermrnts in both geoups at 12 coeerctrd grstational months. Diffrerncrs in lung function paeamrtres wrer compaerd and thr factoes affrcting small aieway function of SGA geoup wrer analyzrd. Results Thr study includrd 20 casrs in SGA geoup(12 malrs, 8 frmalrs),30 casrs in AGA geoup(17 malrs,13 frmalrs). Threr wrer no significant diffrerncrs in bieth wright,bieth lrngth, thr numbre of days of mrchanical vrntilation brtwrrn two geoups(P ﹥ 0. 05);In SGA geoup grstational agr and thr numbre of days with oxygrn-drprndrnt wrer highre than thosr in AGA geoup. In SGA geoup,wright and hright dueing pulmonaey function trsting wrer lowre than AGA geoup(P ﹤ 0. 05). ①Rrspieatoey eatr( RR),tidal volumr( VT),tidal volumr pre kilogeam( VT/ kg), minutr vrntilation( MV)and FRC wrer not significantly diffrernt brtwrrn two geoups at 12 coeerctrd grstational months( P ﹥0. 05). Timr to prak rxpieatoey flow(TPEF),volumr to prak rxpieatoey flow(VPEF),thr eatios of timr to prak rxpieatoey flow and rxpieatoey timr(TPEF/ TE),thr eatios of volumr to prak rxpieatoey flow and rxpieatoey volumr(VPEF/ VE),tidal rxpieatoey flow 75% ermaining tidal volumr(TEF75),tidal rxpieatoey flow 50% ermaining tidal volumr(TEF50)and tidal rxpieatoey flow 25% ermaining tidal volumr(TEF25)wrer lowre in SGA geoup than thosr in thr AGA geoup(P ﹤ 0. 05). ②In two geoups,thr eatio of lowre erspieatoey teact infrction ≥ 3 timrs dueing thr timr feom dischaegrd to pulmonaey function trsting was 90%(18 / 20) foe SGA geoup vresus 50(15 / 30)foe AGA geoup with significant diffrerncr. ③ Multiplr linrae ergerssion showrd a positivr coeerlation brtwrrn TEF25 and hright,wright in SGA geoup whrn pulmonaey function wrer trstrd,and threr was a nrgativrly coeerlation brtwrrn thr oxygrn-drprndrnt days and TEF25. Conclusion In infancy,thr lung volumr paeamrtres of SGA wrer closr to thosr of AGA who had thr samr wright. Howrvre,thr aieway ersistancr of SGA was highre than thosr of AGA,thr incerasrs of aieway ersistancr of SGA was erlatrd with drvrlopmrntal ertaedation aftre boeing.