PULMONARY-FUNCTION AND CLINICAL COURSE IN PATIENTS WITH CYSTIC-FIBROSIS AFTER PULMONARY COLONIZATION WITH PSEUDOMONAS-AERUGINOSA
PULMONARY-FUNCTION AND CLINICAL COURSE IN PATIENTS WITH CYSTIC-FIBROSIS AFTER PULMONARY COLONIZATION WITH PSEUDOMONAS-AERUGINOSA
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DOI：
10.1016/s0022-3476(05)82653-8
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发表时间：
1990-05-01
影响因子：
5.1
通讯作者：
LEVISON, H
中科院分区：
文献类型：
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作者：
KEREM, E;COREY, M;LEVISON, H
为了评价铜绿假单胞菌定植与肺部疾病发展之间的关系，我们研究了1975年至1988年期间在我们的囊性纤维化诊所就诊的895例患者。铜绿假单胞菌定植率为82%。在出生后第一年获得铜绿假单胞菌的患者的10年生存率（85%）与1至7岁之间的患者（87%）以及7岁以后的患者（78%）相似。定植前1年，平均年龄、1秒用力呼气容积（FEV 1）、用力肺活量和呼气中期用力呼气流量与未感染铜绿假单胞菌的患者组相似。定植后1年和2年，肺功能变量无显著变化。与定植前相比，铜绿假单胞菌感染后的住院率和住院时间没有增加。到7岁时，已经被铜绿假单胞菌定殖的患者与未被定殖的患者相比，预测的FEV 1的平均百分比低10%（p < 0.01）。在7 - 35岁的所有年龄段均观察到FEV 1类似的降低，但FEV 1的下降速率与铜绿假单胞菌定植无关。我们的结论是，虽然铜绿假单胞菌定植与肺功能降低10%相关，但它并不像以前报道的那样引起立即和快速的降低。铜绿假单胞菌定植后囊性纤维化的临床病程和肺部恶化是一个渐进和可变的过程。
To evaluate the relationship between Pseudomonas aeruginosa colonization and the development of lung disease, we studied 895 patients who attended our cystic fibrosis clinic between 1975 and 1988. The prevalence of P. aeruginosa colonization was 82%. Patients who acquired P. aeruginosa in the first year of life had a similar 10-year survival rate (85%) to that in patients who were colonized betwen the ages of 1 and 7 years (87%), and to that in patients colonized after the age of 7 years (78%). One year before colonization, mean age, forced expiratory volumein 1 second (FEV1), forced vital capacity, and forced expiratory flow in the mid-expiratory phase were similar to those in a group of patients who remained free of P. aeruginosa. No significant change in pulmonary function variables could be demonstrated 1 year and 2 years after the colonization. The rate and duration of hospitalization did not increase in the years after P. aeruginosa compared with the years before colonization. By the age of 7 years, the mean percentage of predicted FEV1 was lower by 10% in patients who were already colonized by P. aeruginosa compared with those who were not colonized (p < 0.01). A similar reduction in FEV1 was observed at all ages from 7 to 35 years, but no precipitate rate of decline in FEV1 could be associated with P. aeruginosa colonization. We conclude that although P. aeruginosa colonization is associated with 10% lower lung function, it does not cause an immediate and rapid reduction, as has been previously reported. The clinical course and the pulmonary deterioration in cystic fibrosis after P. aeruginosa colonization is a gradual and variable process.