Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function

Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function
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DOI：
10.1136/thx.2009.125831
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发表时间：
2010-05-01
期刊：
THORAX
影响因子：
10
通讯作者：
Ratjen, Felix
Ratjen, Felix
中科院分区：
医学1区
文献类型：
--
作者：
Amin, Reshma;Subbarao, Padmaja;Ratjen, Felix

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背景和目的目前缺乏评估囊性纤维化（CF）伴轻度肺部疾病患者治疗干预疗效的敏感结局指标。我们的目的是研究的能力，肺清除指数（LCI），通气不均匀性的措施，检测治疗反应，以高渗盐水吸入在儿科患者CF与肺功能正常spirometry.Methods交叉试验，20例CF患者接受了4周的高渗盐水（HS）和等渗盐水（IS）在一个随机序列分开的4周洗脱期。主要终点是在LCI的变化，由于HS与IS.Results基线特征，包括LCI两个研究期间之间没有显着差异。与IS相比，每天两次吸入HS四周显著改善了LCI（1.16，95% CI 0.26至2.05; p=0.016），而其他结局指标（如肺功能测定和生活质量）未能达到统计学显著性。随机化顺序没有显着的影响治疗effects.Conclusions的LCI，但不是肺功能测定能够检测到HS吸入CF患者的治疗效果与轻度疾病，可能是一个合适的工具，以评估早期干预策略，在这个患者群体。
Background and aims Sensitive outcome measures to assess the efficacy of therapeutic interventions in patients with cystic fibrosis (CF) with mild lung disease are currently lacking. Our objective was to study the ability of the lung clearance index (LCI), a measure of ventilation inhomogeneity, to detect a treatment response to hypertonic saline inhalation in paediatric patients with CF with normal spirometry.Methods In a crossover trial, 20 patients with CF received 4 weeks of hypertonic saline (HS) and isotonic saline (IS) in a randomised sequence separated by a 4 week washout period. The primary end point was the change in the LCI due to HS versus IS.Results Baseline characteristics including the LCI were not significantly different between both study periods. Four weeks of twice-daily HS inhalation significantly improved the LCI compared with IS (1.16, 95% CI 0.26 to 2.05; p=0.016), whereas other outcome measures such as spirometry and quality of life failed to reach statistical significance. Randomisation order had no significant impact on the treatment effect.Conclusions The LCI, but not spirometry was able to detect a treatment effect from HS inhalation in patients with CF with mild disease and may be a suitable tool to assess early intervention strategies in this patient population.