Poor recovery from cystic fibrosis pulmonary exacerbations is associated with poor long-term outcomes.

Poor recovery from cystic fibrosis pulmonary exacerbations is associated with poor long-term outcomes.
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DOI:
10.1002/ppul.23765
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发表时间:
2017-10
影响因子:
3.1
通讯作者:
Farrell PM
Farrell PM
中科院分区:
医学3区
文献类型:
--
作者:
Sanders DB;Zhao Q;Li Z;Farrell PM

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因肺部病情加重 (PEx) 而接受静脉注射抗生素治疗的 CF 患者经常无法恢复至基线 FEV1。这些事件的长期影响尚未得到研究。确定患者在 PEx 后的肺量恢复情况是否与 1 年内进行下一次 PEx 的时间、下一次 PEx 后的肺量恢复情况和/或未来 3 年内的 PEx 发作次数相关。我们使用了 2004 年至 2011 年 CF 基金会患者登记处的数据。我们为每位患者随机选择一名符合纳入/排除标准的 PEx。如果患者在 PEx 后 3 个月内记录的最佳 FEV1(以升为单位)<PEx 前 6 个月内最佳 FEV1(以升为单位)的 90%,则被定义为无反应者。我们使用多变量回归模型比较了响应者和无响应者。我们随机选择了 13,954 个符合纳入/排除标准的 PEx 剧集。 2,762 名 (19.8%) 患者被归类为无反应者。无应答者到下一次 PEx 的中位时间较短,为 235 (95% CI 218, 252) 天,而应答者则超过 365 天。初次 PEx 中 34% 的无应答者在下一次 PEx 中也是无应答者,而初次 PEx 中只有 20% 的应答者。在接下来的 3 年中,无应答者的 PEx 发作次数较多,为 4.99 次(95% CI 4.84, 5.13),而应答者则为 3.46 次(95% CI 3.41, 3.51)。 PEx 后恢复不良与下一次 PEx 的时间较短、第二次 PEx 恢复不良的风险增加以及后续 PEx 治疗的频率增加有关。
People with CF treated with IV antibiotics for a pulmonary exacerbation (PEx) frequently fail to recover to baseline FEV1. The long-term impact of these events has not been studied. To determine if a patient’s spirometric recovery after a PEx is associated with time to next PEx within 1 year, the spirometric recovery after the next PEx, and/or the number of PEx episodes in the next 3 years. We used data from the CF Foundation Patient Registry from 2004–2011. We randomly selected one PEx per patient that met inclusion/exclusion criteria. Patients were defined as Non-Responders if their best FEV1 (in liters) recorded in the 3 months after the PEx was <90% of the best FEV1 (in liters) in the 6 months before the PEx. We compared Responders and Non-Responders using multivariable regression models. We randomly chose 13,954 PEx episodes that met inclusion/exclusion criteria. 2,762 (19.8%) patients were classified as Non-Responders. Non-Responders had a shorter median time to the next PEx, 235 (95% CI 218, 252) days, versus >365 days for Responders. Thirty-four percent of Non-Responders at the initial PEx were also Non-Reponders at the next PEx, versus 20% of Responders at the initial PEx. Non-Responders had more PEx episodes over the next 3 years, 4.99 (95% CI 4.84, 5.13), than Responders, 3.46 (95% CI 3.41, 3.51). Poor recovery after a PEx is associated with a shorter time to the next PEx, increased risk of poor recovery at a second PEx, and more frequent subsequent PEx treatments.
3-95 岁年龄范围的多种族肺活量测定参考值:2012 年全球肺功能方程。
DOI: 10.1183/09031936.00080312
发表时间: 2012-12
期刊: The European respiratory journal
影响因子: --
作者:
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通讯作者: ERS Global Lung Function Initiative
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DOI: 10.1378/chest.12-1404
发表时间: 2013-09-01
期刊: CHEST
影响因子: 9.6
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发表时间: 2001-05-01
影响因子: 24.7
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Schechter, MS;Shelton, BJ;Fitzsimmons, SC
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DOI: 10.1542/peds.103.6.e72
发表时间: 1999-06-01
期刊: PEDIATRICS
影响因子: 8
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