肺功能从肺部恶化中恢复治疗口服抗生素在初级纤维动力障碍症中的肺功能
Dvir Gatt1, Michelle Shaw2, Valerie Waters3
1Division of Respiratory Medicine.
Annals of the American Thoracic Society
|December 19, 2024
概括
肺部恶化 (PExs) 用口服抗生素 (oPExs) 治疗的初级纤维动力障碍 (PCD) 患者的肺功能恢复与囊性纤维化 (CF) 患者相似. 年龄较小和先前没有反应是PCD肺功能恢复较差的风险因素.
科学领域:
- 肺部病理学 肺部病理学
- 儿科呼吸系统医学 儿科呼吸系统医学
- 遗传学和罕见疾病
背景情况:
- 初级状动力障碍 (PCD) 患者经历肺部恶化 (PExs),这可能会影响肺功能.
- 在囊性纤维化 (CF) 中,用口服抗生素 (oPExs) 治疗的PEx与肺功能缺陷有关.
- 在PCD中oPExs对肺功能恢复的影响尚未先前评估.
研究的目的:
- 评估oPExs对患有PCD的儿科患者肺功能恢复的影响.
- 确定与PCD治疗oPEx治疗反应较差相关的因素.
主要方法:
- 从2000年到2022年对儿科PCD患者进行了回顾性研究.
- 定义PExs为需要全身抗生素治疗 (口服或静脉注射) 的症状增加.
- 肺功能恢复以1秒内强迫呼气体积 (FEV1) 衡量,在PEx后12个月内≥90%的基线.
主要成果:
- 在85名PCD患者中分析了337次PEx事件;88%的患者接受了oPExs.
- oPExs导致平均FEV1显著下降 (从85.1%降至69.5%).
- 73.2%的患者在oPEx后3个月内恢复了肺功能,在1年内增加到84.2%. 年龄较小和先前对PEx治疗没有反应是不恢复的风险因素.
结论:
- 在PCD患者中的OPEx显示出FEV1下降和随后恢复的模式,反映了CF的发现.
- 大多数PCD患者在OPExs后的一年内恢复肺功能.
- 恶化时的年龄较小和以前对PEx治疗没有反应是PCD中肺功能不完全恢复的关键预测因素.
相关概念视频
COPD: Management Using Bronchodilators and Corticosteroids
177
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
177
Pulmonary Cycle: Exhalation
1.4K
In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
1.4K
Cystic Fibrosis: Management
139
Cystic fibrosis (CF) is an autosomal recessive disorder that predominantly affects individuals of Northern European descent, occurring at a rate of 1 in 3500. It is caused by a genetic mutation in a gene on chromosome 7, most commonly the ΔF508 mutation, that codes for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. This results in thicker mucus secretions and obstruction pathologies in multiple organs, including the lungs and sinuses.
Sinus disease and chronic...
Sinus disease and chronic...
139
Chronic Obstructive Pulmonary Disease-V: Management
2.5K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
2.5K
Acute Respiratory Failure-V
123
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
123
Drugs Used in Lower Respiratory Disorders: Overview
349
Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
349


