Response to the editor
Response to the editor
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对编辑的回应
DOI：
10.1016/j.chest.2021.07.044
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发表时间：
2021
期刊：
影响因子：
9.6
通讯作者：
Suda T.
中科院分区：
文献类型：
--
作者：
Hozumi H;Kono M;Hasegawa H;Yasui H;Suzuki Y;Karayama M;Furuhashi K;Enomoto N;Fujisawa T;Inui N;Nakamura Y;Yokomura K;Nakamura H;Suda T.
我们饶有兴趣地阅读了 Hozumi 等人关于间质性肺疾病 (ILD) 及其在显微镜下多血管炎 (MPA) 中急性加重的临床意义的著作。发表在最近一期的《Chest》上。 1 作者提供了令人信服的数据，支持 MPA-ILD 临床表型的存在，且预后不良，需要不同的治疗方法。 2 然而，令我们惊讶的是，抗生素治疗并未作为协变量纳入 MPA-ILD 组和 MPA-非 ILD 组之间的比较分析或 Cox 比例风险回归分析中。此外，文章的方法部分没有描述抗生素治疗。患有抗中性粒细胞胞浆抗体相关性血管炎（包括 MPA）的患者通常感染感染的风险很高。 3 在此基础上，国际指南建议抗中性粒细胞胞浆抗体相关性血管炎患者预防性使用抗生素（例如复方新诺明）并接种疫苗预防感染。 4 与这一概念相一致的是，最近的一项纵向匹配队列研究表明，患有抗中性粒细胞胞浆抗体的患者的感染风险高达七倍。
We read with great interest the work on the clinical significance of interstitial lung disease (ILD) and its acute exacerbation in microscopic polyangiitis (MPA) by Hozumi et al. published in the recent issue of Chest. 1 The authors provided convincing data supporting the existence of an MPA-ILD clinical phenotype with a poor prognosis that needs a different therapeutic approach. 2 However, we were surprised that treatment with antibiotics was not included as a covariate in the comparative analysis between MPA-ILD and MPA-non-ILD groups or the Cox proportional hazards regression analysis. Further, there is no description of therapy with antibiotics in the method section of the article. Patients with anti-neutrophil cytoplasmic antibody-associated vasculitis, including MPA, are generally at high risk of contracting an infection. 3 On this basis, international guidelines recommend the prophylactic prescription of antibiotics (eg, co-trimoxazole) and vaccination against infection in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis. 4 In agreement with this concept, a recent longitudinal matched-cohort study demonstrated that the risk of infection is up to seven times higher in patients with anti-neutrophil cytoplasmic