评估移植后儿童的呼吸功能
Marine Toubal1, Emma Allain-Launay2, Alexandra Bruel2
1Childhood Chronic Diseases Department, University Hospital of Nantes, 7 Quai Moncousu, 44093, Nantes, France. marine.toubal@chu-nantes.fr.
Pediatric nephrology (Berlin, Germany)
|January 8, 2025
概括
儿童移植接受者经常出现呼吸道并发症. 诸如移植时年龄较大和巴西利克西马布诱导等因素降低了风险,而免疫缺陷和BK病毒增加了风险,需要监测.
科学领域:
- 儿科脏病学 儿科脏病学
- 肺部病理学 肺部病理学
- 移植医学 移植医学
背景情况:
- 已知移植后的严重呼吸道并发症,但对儿童的了解很少.
- 这项研究解决了关于儿科移植患者呼吸系统疾病发病率和风险因素的知识差距.
研究的目的:
- 记录移植后儿童呼吸系统疾病的流行率和特征.
- 确定与此脆弱人群中呼吸道并发症相关的临床和人口因素.
主要方法:
- 年度后续评估包括呼吸道症状问卷和肺功能测试 (PFT).
- 呼吸系统疾病是由临床疾病和/或异常的PFT结果来定义的.
- 多变量分析确定了呼吸道参与的危险因素.
主要成果:
- 在236名儿科移植接受者中,有41%的患者出现呼吸系统干扰.
- 在PFT异常中注意到阻塞性损伤,限制性损伤和扩散能力降低 (DLCO/KCO).
- 移植时的年龄较大 (>3.5岁) 和巴西力西马布诱导与降低的风险相关;免疫缺陷,男性性别,BK病毒和高血压的风险增加.
结论:
- 儿童移植接受者面临呼吸道并发症的重大风险,包括不可逆转的肺损伤.
- 建议对患有呼吸道症状,复发性感染或已确定的风险因素的儿童进行系统的临床和功能性呼吸系统监测.
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