上顎の急速な拡大がスパイロメトリーで評価される呼吸機能に及ぼす短期的影響。症例対照研究

Short term effects of rapid maxillary expansion on breathing function assessed with spirometry: A case-control study.

抄録

背景:

この研究の目的は、口呼吸者と鼻呼吸者の2つの患者群において、急速上顎拡大（RME）後の呼吸機能に対する変化を評価することである。

Background: The aim of this work is to evaluate changes following rapid maxillary expansion (RME) on breathing function in two groups of patients: mouth breathers and nasal breathers.

材料と方法:

口腔呼吸器患者25名（男性12名，女性13名，平均年齢15.2±1.3歳），鼻腔呼吸器患者25名（男性14名，女性11名，平均年齢15.3±1.6歳）にRMEを行った。呼吸機能はコンピュータ・スパイロメトリーで評価した．強制換気量（FVC），強制呼気1秒量（FEV1），Tiffenau index（FEV1/ FVC比，IT％），強制呼気量25～75％時（FEF25～75％），Tidal volume（TV）を評価した．呼吸機能解析は、RME前、RME後6ヶ月および12ヶ月のフォローアップ診察時に実施した。データが正規分布しているかどうかを評価するためにShapiro-Wilk検定を使用した。データが正規分布していないため、治療群間および群内比較には、それぞれMann-Whitney U検定およびFriedman検定を使用した。

Materials and methods: Twenty-five oral breather patients (12 male, 13 female, mean age 15.2 ± 1.3), and 25 nasal breather patients (14 male, 11 female, mean age 15.3 ± 1.6) were treated with RME. Breathing function was evaluated by computerized spirometry. Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), Tiffenau index (FEV1/ FVC ratio, IT%), forced expiratory flow at 25-75% of vital capacity (FEF 25-75%), and Tidal volume (TV) were assessed. Breathing function analysis was performed before RME and 6 and 12 months after RME during follow-up appointments. The Shapiro-Wilk test was used to assess whether data were normally distributed. As data were not normally distributed, Mann-Whitney U and Friedman tests were used to perform comparisons between treatment groups and within group comparisons, respectively.

結果:

口腔呼吸器と鼻腔呼吸器では、T0においてFVC、FEF25-75％、TVに統計的に有意な差が認められた。上顎拡大後，口腔呼吸器群ではすべての指標に統計的有意差が認められたが，鼻腔呼吸器群では治療後FCV，FEF 25-75％およびTVのみに統計的有意差が認められた．

Results: Oral breathers and nasal breathers showed statistically significant differences in FVC, FEF 25-75%, and TV at T0. They did not present any statistically significant difference in FEV1 and IT% at the same time point.Statistically significant differences were noticed for all indices in the oral breather group after maxillary expansion, while the nasal breather group showed statistically significant differences only in FCV, FEF 25-75%, and TV after treatment.There were no statistically significant differences in all indices 12 months after maxillary expansion between the oral breather and nasal breather groups.

結論:

RMEは両群とも呼吸機能を改善するようであった。強制換気量（FVC）、25-75％強制換気量（FEF 25-75）、潮汐量（TV）はRME治療後、両群で同程度の値に達した。

Conclusions: RME appeared to improve breathing function in both groups. Forced vital capacity (FVC), forced expiratory flow at 25-75% of vital capacity (FEF 25-75), and Tidal volume (TV) reached similar values in both groups after treatment with RME.