同时异常的非酸性反流与肺移植患者增加酸性暴露的慢性排斥风险相关
Wai-Kit Lo1,2,3, Mayssan Muftah1,3, Hilary J Goldberg3,4
1Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA.
概括
非酸性逆流,与酸性逆流一起,显著增加了肺移植接受者慢性肺异位功能障碍 (CLAD) 的风险. 这一发现表明非酸性反流可能在全移植排斥中发挥作用,突显了阻抗测试的重要性.
科学领域:
- 胃肠病学和移植外科手术
- 肺部医学和免疫学
背景情况:
- 酸性反流与肺移植排斥有关,但非酸性反流的作用尚不清楚.
- 了解非酸性反流的影响对于管理肺移植接受者至关重要.
研究的目的:
- 评估异常非酸性逆流与酸性逆流同时对肺移植患者慢性排斥的影响.
- 调查非酸性反流对慢性肺异位移植功能障碍 (CLAD) 的独立贡献.
主要方法:
- 肺移植接受者的回顾性队列研究,在移植前进行阻抗-pH测试以测试酸性抑制.
- 纳入标准:酸性暴露>4%;非酸性反流异常定义为>27次 (pH>4).
- 使用卡普兰-梅尔和考克斯回归来评估CLAD风险的时间到事件分析.
主要成果:
- 包括68名患者:28名患有异常非酸性反流,40名患有正常非酸性反流.
- 同时出现异常的非酸性反流与显著更高的CLAD风险相关 (日志排名P=0.0269).
- 多变量分析证实非酸性反流异常是增加CLAD风险的独立预测因子 (HR2.31,P=0.04).
结论:
- 肺移植患者同时出现异常的非酸性反流,而酸性暴露增加,会增加慢性排斥 (CLAD) 的风险.
- 非酸性反流可能会导致肺异体移植损伤和排斥.
- 基于阻抗的测试可能对评估肺移植人群中非酸性反流有价值.
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