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稳定期囊性纤维化婴儿的脱氧核糖核酸酶:一项试点研究。

DNase in stable cystic fibrosis infants: a pilot study.

作者信息

Berge Maartje Ten, Wiel Els van der, Tiddens Harm A W M, Merkus Peter J F M, Hop Wim C J, de Jongste Johan C

机构信息

Department of Pediatrics, division of Respiratory Medicine, Erasmus MC--University Medical Center Rotterdam/Sophia Children's Hospital, P.O. Box 2060, 3000, CB, Rotterdam, Netherlands.

出版信息

J Cyst Fibros. 2003 Dec;2(4):183-8. doi: 10.1016/S1569-1993(03)00090-0.

Abstract

OBJECTIVE

To assess the feasibility of measuring short-term effects of inhaled recombinant human deoxyribonuclease (rhDNase, Pulmozyme on lung function, pulse oximetry and symptom scores in infants and toddlers with stable cystic fibrosis.

DESIGN

open-label randomized placebo controlled cross-over pilot study.

PATIENTS AND METHODS

We treated nine CF patients (0.7-1.9 years) with nebulised rhDNase (2.5 mg) and NaCl 0.9% (10 ml) via jet nebulizer cross-over once daily during 2-week treatment blocks. Measurements were performed at baseline and after treatment blocks and consisted of lung function tests (plethysmography and tidal rapid thoraco-abdominal compression technique), overnight pulse oximetry, and daily symptom scores.

RESULTS

DNase treatment and the different assessments were well tolerated by all children and their parents. Lung function showed increased airway patency after treatment with rhDNase (P < 0.001), but not after NaCl 0.9%. Overnight pulse oximetry and daily symptom scores did not change during the study period.

CONCLUSIONS

This pilot study indicates that objective assessment of the effects of rhDNase is feasible in infants with CF who have little or no respiratory symptoms. Our results warrant a larger randomized placebo-controlled trial.

摘要

目的

评估吸入重组人脱氧核糖核酸酶(rhDNase,普米克令舒)对稳定期囊性纤维化婴幼儿肺功能、脉搏血氧饱和度及症状评分的短期影响的可行性。

设计

开放标签随机安慰剂对照交叉试验性研究。

患者与方法

我们对9例囊性纤维化患者(0.7 - 1.9岁)进行治疗,在为期2周的治疗周期内,通过喷射雾化器每天交叉给予雾化吸入rhDNase(2.5毫克)和0.9%氯化钠溶液(10毫升)。在基线期和治疗周期结束后进行测量,测量项目包括肺功能测试(体积描记法和潮气快速胸腹压迫技术)、夜间脉搏血氧饱和度及每日症状评分。

结果

所有儿童及其家长对DNase治疗和不同评估的耐受性良好。rhDNase治疗后肺功能显示气道通畅性增加(P < 0.001),而0.9%氯化钠溶液治疗后未出现此情况。在研究期间,夜间脉搏血氧饱和度和每日症状评分未发生变化。

结论

这项试验性研究表明,对于几乎没有或没有呼吸道症状的囊性纤维化婴幼儿,客观评估rhDNase的效果是可行的。我们的结果表明有必要进行一项更大规模的随机安慰剂对照试验。

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