The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis
The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis
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DOI：
10.1183/09031936.06.00074605
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发表时间：
2006-11-01
影响因子：
24.3
通讯作者：
Wilson, R.
中科院分区：
文献类型：
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作者：
Davies, G.;Wells, A. U.;Wilson, R.
支气管扩张患者易感染铜绿假单胞菌。隔离与疾病的严重程度增加、气流阻塞更严重和生活质量更差有关。目前尚不清楚铜绿假单胞菌感染是否是疾病严重程度的标志或有助于疾病进展。根据铜绿假单胞菌的分离，将连续性非囊性纤维化成人支气管扩张门诊患者（n=163）多次痰培养和随访肺功能检查指定为“从未感染”。（组1; n=67）、“间歇隔离”（组2; n=82）和“慢性感染”（组3; n=14）。根据出现症状后2年内1秒用力呼气量（FEV 1）%预测值的变化，纵向行为被描述为“改善”（上升>= 10%）、“下降”（下降>= 10%）或“稳定”。基线肺功能测试和纵向行为与假性肺炎状态的关系进行了检查。两组在年龄、性别、吸烟习惯或随访时间方面没有差异。第1组的基线FEV 1水平最高（平均值+/- SD：77.4 +/- 24.3），第2组（67.3 +/- 25.7）高于第3组（55.2 +/- 18.5）。基线FEV 1/用力肺活量比和肺弥散量对一氧化碳水平的影响也有相同的显著趋势。随后的纵向行为与基线FEV 1水平相关，FEV 1水平在改善患者中最低，与下降的相关性低于稳定性。然而，无论是调整基线FEV 1水平之前还是之后，第1、2和3组之间的纵向行为没有差异。
Bronchiectasis patients are susceptible to infection with Pseudomonas aeruginosa. Isolation is associated with increased severity of disease, greater airflow obstruction and poorer quality of life. It is not known whether infection by P. aeruginosa is a marker of disease severity or contributes to disease progression.Consecutive non-cystic fibrosis adult bronchiectasis outpatients (n=163) with multiple sputum cultures and follow-up pulmonary function tests were designated, according to isolation of P. aeruginosa, as "never infected" (group 1; n=67), "intermittently isolated" (group 2; n=82) and "chronically infected" (group 3; n=14). Based upon change in forced expiratory volume in one second (FEV1) % predicted levels at >= 2 yrs after presentation, longitudinal behaviour was characterised as "improvement" (>= 10% rise), "decline" (>= 10% fall) or "stability". Baseline pulmonary-function tests and longitudinal behaviour were examined in relation to pseudomonas status.There was no difference between the groups in age, sex, smoking habit or length of follow-up. Baseline FEV1 levels were highest in group 1 (mean +/- SD: 77.4 +/- 24.3) and higher in group 2 (67.3 +/- 25.7) than in group 3 (55.2 +/- 18.5). The same significant trends were seen for baseline FEV1/forced vital capacity ratios and diffusing capacity of the lung for carbon monoxide levels. Subsequent longitudinal behaviour was linked to baseline FEV1 levels, which were lowest in patients with improvement and lower in association with decline than with stability. However, longitudinal behaviour did not differ between groups 1, 2 and 3, either before or after adjustment for baseline FEV1 levels.