Improvement in pulmonary function following antibiotics in infants with cystic fibrosis
Improvement in pulmonary function following antibiotics in infants with cystic fibrosis
复制标题
DOI：
10.1002/ppul.21575
复制
发表时间：
2012-05-01
影响因子：
3.1
通讯作者：
Davis, Stephanie D.
中科院分区：
文献类型：
--
作者：
Pittman, Jessica E.;Johnson, Robin C.;Davis, Stephanie D.
背景：最近的研究表明，即使是无症状的囊性纤维化(CF)婴儿也会出现肺部疾病。虽然肺功能测试(PFT)经常被用来跟踪肺疾病的进展并指导大龄CF儿童的治疗，但关于CF儿童婴儿PFT变化的数据很少。目的：探讨婴幼儿慢性阻塞性肺疾病肺加重抗生素治疗前后肺功能的变化。方法：对在北卡罗来纳大学教堂山分校接受临床指征的婴幼儿肺纤维化肺加重抗生素治疗前后接受PFTs治疗的CF患儿进行回顾性队列研究。结果：11例CF患儿有抗生素治疗前后的PFT数据，首次PFT的平均年龄为102周。大多数婴儿在服用抗生素之前就有症状，在治疗后临床参数显示出显著改善。在使用抗生素之前，PFT显示了实质性阻塞性疾病的证据(FVC、FEV0.5和FEF25-75的平均z分数分别为-1.81、-3.06和-4.5)和空气滞留/过度充气(FRCpleth、RV和RV/TLC的平均z分数分别为8.86、7.1和3.31)。抗生素治疗后，上述参数均有统计学意义的改善。讨论：在11名患有CF的婴儿中，我们已经显示在抗生素治疗后婴儿PFT测量有统计学意义的改善，这与临床参数的改善是平行的。虽然婴儿PFTs有所改善，但在大多数受试者中仍然异常，抗生素治疗后持续存在空气滞留和过度充气。我们的研究结果表明，婴儿PFT对儿童CF的急性临床变化很敏感，可能是治疗儿童CF的有用工具。儿科肺单醇。2012；47：441-446。(C)2011年威利期刊公司。
Background Recent studies have shown the presence of lung disease in even asymptomatic infants with cystic fibrosis (CF). While pulmonary function testing (PFT) is often used to follow progression of lung disease and guide treatment in older children with CF, little data is available on change in infant PFTs in young children with CF. Objective: To determine change in infant PFTs before and after antibiotic therapy for pulmonary exacerbation in infants with CF. Methods: Retrospective cohort study of infants with CF who underwent clinically indicated infant PFTs before and after antibiotic therapy for CF pulmonary exacerbation at the University of North Carolina at Chapel Hill. Results: Pre- and post-antibiotics PFT data was available on 11 infants with CF, with a mean age of 102 weeks at time of first PFT. The majority of infants were symptomatic prior to antibiotics, and showed statistically significant improvement in clinical parameters following treatment. Prior to antibiotics, PFTs showed evidence of substantial obstructive disease (mean z-scores for FVC, FEV0.5, and FEF25-75 of -1.81, -3.06, and -4.5, respectively) and air-trapping/hyperinflation (mean z-scores for FRCpleth, RV, and RV/TLC of 8.86, 7.1, and 3.31, respectively). Following antibiotics, all of the above parameters showed statistically significant improvement. Discussion: We have shown a statistically significant improvement in infant PFT measures following antibiotic therapy in a cohort of 11 infants with CF, which paralleled improvement in clinical parameters. Though infant PFTs showed improvement, they remained abnormal in the majority of subjects, with persistent air-trapping and hyperinflation after antibiotic therapy. Our findings suggest that infant PFTs are sensitive to acute clinical changes in children with CF, and may be a useful tool in managing infants with CF. Pediatr Pulmonol. 2012; 47: 441-446. (C) 2011 Wiley Periodicals, Inc.