THE AGE AT ONSET OF CHRONIC PSEUDOMONAS-AERUGINOSA COLONIZATION IN CYSTIC-FIBROSIS - PROGNOSTIC-SIGNIFICANCE
THE AGE AT ONSET OF CHRONIC PSEUDOMONAS-AERUGINOSA COLONIZATION IN CYSTIC-FIBROSIS - PROGNOSTIC-SIGNIFICANCE
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DOI：
10.1007/bf02191510
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发表时间：
1995-01-01
影响因子：
3.6
通讯作者：
KRAEMER, R
中科院分区：
文献类型：
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作者：
AEBI, C;BRACHER, R;KRAEMER, R
为了评估慢性铜绿假单胞菌定植 (OPCP) 发病年龄与囊性纤维化 (CF) 患者肺部疾病进展的预后意义，对 54 名囊性纤维化 (CF) 患者进行了年度胸部 X 线照片的回顾性长期分析。 37 名患者 (68%) 在 12 岁之前长期定植（第 1 组），17 名患者 (32%) 在此后（第 2 组）。研究期间，这两组在平均随访时间（16.2 +/- 5.9 年）、性别、CF 基因型、其他呼吸道病原体定植、支持性医疗和死亡率方面没有显着差异。胸部X光片根据Chrispin-Norman评分进行评估，评分增加代表呼吸道疾病的严重程度增加。在两组中，在 OCPC 后 6 年内，评分平均值的进展并未加速（OCPC 评分设置为 0；OCPC 前 6 年平均评分 +/- SEM - 5.6 +/- 2.0；OCPC 后 10 年 + 3.6 +/- 0.7 分）。与第 2 组相比，12 岁之前慢性定植的患者（第 1 组）在 2 岁至 11 岁之间的得分显着更高（最大差异在 8 岁时[平均值 +/- SEM]：9.4 +/- 0.7 分 vs. 4.3 +/- 1.3 分；P = 0.002）。在 2 岁之后，两组的平均得分相似，因为在第 2 岁之后，第 2 组得分迅速增加。我们的结论是，根据系列胸片判断，OCPC 不会立即加速 CF 肺部疾病。第 2 组（12 岁后出现 OCPC）的快速进展与 OCPC 无关，因为它发生得更早。这些数据表明 OCPC 可能是呼吸系统疾病进展的一个标志物而不是原因。
To evaluate the prognostic significance of the age at onset of chronic Pseudomonas aeruginosa colonization (OPCP) with respect to pulmonary disease progression in patients with cystic fibrosis (CF), a retrospective long-term analysis using annual chest radiographs was performed on 54 CF patients. Thirty-seven patients (68%) were chronically colonized before the age of 12 years (group 1), 17 patients (32%) thereafter (group 2). These two groups did not significantly differ in terms of mean duration of follow up (16.2 +/- 5.9 years), sex, CF genotypes, colonization with other respiratory pathogens, supportive medical treatment and death rate during the study period. Chest radiographs were evaluated according to the Chrispin-Norman score, increasing scores representing increasing severity of respiratory disease. Ln both groups, progression of score means was not accelerated up to 6 years after OCPC (Scores at OCPC set 0; mean score +/- SEM 6 years prior to OCPC - 5.6 +/- 2.0; 10 years after OCPC + 3.6 +/- 0.7 points). Patients chronically colonized prior to age 12 years (group 1) scored significantly higher between age 2 and 11 years (maximum difference at age 8 years [mean +/- SEM]: 9.4 +/- 0.7 vs. 4.3 +/- 1.3 points; P = 0.002) as compared to group 2. After age ii years, mean scores were similar in both groups, since in group 2 scores increased rapidly after age s years. We conclude that OCPC did not cause an immediate acceleration of CF lung disease judged by serial chest radiographs. Rapid progression in group 2 (OCPC after age 12 years) was independent of OCPC since it occurred earlier. These data indicate that OCPC may be a marker rather than the cause of respiratory disease progression.