在移植前的反流检测中增加的反流负担独立地预测了肺移植后的显著肺功能下降
Wai-Kit Lo1, Annel M Fernandez2, Natan Feldman1
1Department of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Boston, MA 02115, United States.
World journal of transplantation
|August 29, 2025
概括
肺移植前胃食管逆流症负担增加与手术后肺功能减弱有关. 移植前的反流检测可以帮助预测移植后的结果,并指导治疗策略.
科学领域:
- 肺部医学
- 移植手术
- 胃肠病学
背景情况:
- 胃食道反流病 (GERD) 涉及到肺部移植损伤和排斥.
- 移植前逆流检测对肺移植后肺功能下降的预测价值尚不清楚.
研究的目的:
- 研究移植前反流措施与接受肺移植患者肺功能下降之间的联系.
- 确定反流负担是否预测移植后1秒内强制呼气体积 (FEV1) 的减少.
主要方法:
- 对70名肺移植患者进行了24小时pH阻抗测试,以抑制酸性.
- 使用Cox比例危险模型进行时间到事件分析,以评估反流量测量和FEV1下降≥20%之间的关系.
- 在移植前进行基底移植的患者排除;在基底移植,最后一次访问或死亡时进行审查.
主要成果:
- 在26%的受试者中出现了≥20%的FEV1下降.
- 增加的酸暴露时间 (AET) 和近位酸反流与FEV1的下降显著相关 (单变体和多变体分析).
- 所有经历FEV1下降的异常AET受试者都发展为支气管炎消灭综合征.
结论:
- 移植前反流量增加与肺移植后肺功能显著下降有关.
- 移植前的反流评估为肺移植患者的管理提供了有价值的预后信息.
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