Antibody response to Pseudomonas aeruginosa in cystic fibrosis patients:: A marker of therapeutic success?: A 30-year cohort study of survival in Danish CF patients after onset of chronic P aeruginosa lung infection
Antibody response to Pseudomonas aeruginosa in cystic fibrosis patients:: A marker of therapeutic success?: A 30-year cohort study of survival in Danish CF patients after onset of chronic P aeruginosa lung infection
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DOI：
10.1002/ppul.10457
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发表时间：
2004-05-01
影响因子：
3.1
通讯作者：
Hoiby, N
中科院分区：
文献类型：
--
作者：
Johansen, HK;Norregaard, L;Hoiby, N
我们研究了5个连续队列共157名丹麦囊性纤维化患者获得慢性铜绿假单胞菌肺部感染后，越来越多的强化治疗方案对抗假单胞菌抗体应答和生存率的影响。时间段为1971-1975（N=21）、1976-1980（N=64）、1981-1986（N=27）、1987-1993（N=26）和1994-2000（N=19）。在这30年的时间里，我们在所有慢性感染患者中引入了每三个月一次的选择性2周化疗疗程，当非定植患者痰中培养出铜绿假单胞菌时，早期积极治疗吸入粘菌素和口服环丙沙星3个月，并吸入重组人道酶α。慢性铜绿假单胞菌感染的日历年与随后的沉淀素水平升高之间存在显著相关性（P < 0.00001）。在最老的日历年队列中，降水量的中位数每年增加5，而在最年轻的队列中，每年增加1。慢性铜绿假单胞菌的发病年龄中位数从1981-1986年的9.3岁增加到1987-2000年的13.8岁。获得慢性铜绿假单胞菌肺部感染后的生存率随时间而改善（P=0.008）。我们的研究表明，CF患者谁是密集治疗有较低的抗体反应和较长的生存后获得慢性铜绿假单胞菌肺部感染。(C)2004 Wiley-Liss，Inc.
We studied the effects of increasingly intensive treatment regimens on antipseudomonal antibody response and survival in five successive cohorts of a total of 157 Danish cystic fibrosis patients after they had acquired chronic P. aeruginosa lung infection. The time periods were 1971-1975 (N=21), 1976-1980 (N=64), 1981-1986 (N=27), 1987-1993 (N=26), and 1994-2000 (N=19). During this 30-year period, we introduced elective 2-week courses of chemotherapy every third month in all chronically infected patients, early aggressive treatment with inhalation of colistin and oral ciprofloxacin for 3 months whenever P. aeruginosa was cultured in sputum from noncolonized patients, and inhalation of recombinant human dornase alfa. There was a significant correlation between the calendar year when chronic P. aeruginosa infection was acquired and the subsequent increase in the level of precipitins (P < 0.00001). The median number of precipitins increased by 5 per year in the oldest calendar year cohort, and 1 per year in the youngest. The median age of onset of chronic P. aeruginosa increased from 9.3 years from 1981-1986 to 13.8 years from 1987-2000. Survival after acquisition of chronic P. aeruginosa lung infection improved with time (P=0.008). Our study shows that CF patients who are treated intensively have lower antibody responses and longer survival after acquisition of chronic P. aeruginosa lung infection. (C) 2004 Wiley-Liss, Inc.