McPhail Gary L, Acton James D, Fenchel Matthew C, Amin Raouf S, Seid Michael
Division of Pulmonary Medicine, University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
J Pediatr. 2008 Dec;153(6):752-7. doi: 10.1016/j.jpeds.2008.07.011. Epub 2008 Aug 29.
To compare lung function and nutritional outcomes in cystic fibrosis (CF) for 2 birth cohorts in our CF center.
Patients with CF born between 1985 and 2000 treated in our CF center before age 5 years were included. The patients were divided into 2 equal birth cohorts for comparison: birth cohort 1 (born between 1985 and 1992) and birth cohort 2 (born between 1993 and 2000). To compare lung function, we used forced expiratory volume in the first second (FEV(1))% predicted and FEV(1)% predicted slope from age 6 to 12 years. We hypothesized that we would find significant improvements in lung function and nutritional outcomes in our patients with CF.
The patients born between 1993 and 2000 (birth cohort 2) had better lung function, a slower rate of decline in lung function, and better nutritional outcomes compared with those born between 1985 and 1992 (birth cohort 1). Factors associated with a slower rate of decline in lung function in both groups were a higher baseline body mass index (BMI)%, a slower BMI% rate of decline, absence of chronic Pseudomonas aeruginosa respiratory infection, and initiation of dornase alfa (Pulmozyme) therapy before age 9 years.
Our results demonstrate dramatically improved lung function and nutritional outcomes in the children with CF in our center. The improvements in lung function outcomes are associated with better nutrition, fewer chronic P aeruginosa infections, and dornase alfa therapy.
比较我们囊性纤维化(CF)中心两个出生队列的囊性纤维化患者的肺功能和营养状况。
纳入1985年至2000年在我们CF中心5岁前接受治疗的CF患者。将患者分为两个相等的出生队列进行比较:出生队列1(1985年至1992年出生)和出生队列2(1993年至2000年出生)。为比较肺功能,我们使用了6至12岁时第一秒用力呼气量(FEV(1))预测值百分比和FEV(1)预测值斜率。我们假设会发现CF患者的肺功能和营养状况有显著改善。
与1985年至1992年出生的患者(出生队列1)相比,1993年至2000年出生的患者(出生队列2)肺功能更好,肺功能下降速度更慢,营养状况也更好。两组中与肺功能下降速度较慢相关的因素包括较高的基线体重指数(BMI)百分比、较慢的BMI百分比下降速度、无慢性铜绿假单胞菌呼吸道感染以及9岁前开始使用多粘菌素B雾化吸入(Pulmozyme)治疗。
我们的结果表明,我们中心CF患儿的肺功能和营养状况有显著改善。肺功能结果的改善与更好的营养、更少的慢性铜绿假单胞菌感染以及多粘菌素B雾化吸入治疗有关。