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先天性肠闭锁导致囊性纤维化的长期肺部预后

Long-term pulmonary outcome after meconium ileus in cystic fibrosis.

机构信息

Children's University Hospital of the Ludwig-Maximilians-University, Munich, Germany.

出版信息

Pediatr Pulmonol. 2009 Dec;44(12):1201-6. doi: 10.1002/ppul.21119.

Abstract

OBJECTIVE

To identify cystic fibrosis (CF) patients with a history of meconium ileus (MI) and to compare long-term outcome of these patients with CF patients without MI.

PATIENTS

370 CF patients who were treated at the Munich CF centre in 2006, mean age 17.1 years (range: 0-48), were classified with regard to a history of MI.

METHODS

Retrospective chart analysis regarding history of MI, age, and lung function and first detection of Pseudomonas aeruginosa as the primary outcome variables.

RESULTS

We identified 60 patients with MI (16.2% of all patients with a mean age of 16.2 +/- 9 years (0-41) who did not differ in age from patients without MI (17.3 +/- 10; 0-48), whereas the mean age of CF diagnosis was different (0.4 vs. 21.8 months, P < 0.001). Cross sectional analysis of best Forced expiratory volume (FEV% predicted) in 2006 was not different between patients with MI (89 +/- 23%, 17-134) and those without (88 +/- 27%, 21-148, P = 0.73). Longitudinal analysis using FEV1 values of more than 9,000 lung function tests also showed no difference in FEV1 although first detection of P. aeruginosa in patients with MI was significantly earlier.

CONCLUSION

MI was associated with hospitalization, surgery, and early infection with P. aeruginosa. However, the long-term outcome of CF patients with or without MI was the same. This finding might be explained by the considerably earlier CF diagnosis in CF patients with MI including the benefit of an early initiation of appropriate CF therapy.

摘要

目的

确定有胎粪性肠梗阻(MI)病史的囊性纤维化(CF)患者,并比较这些患者与无 MI 的 CF 患者的长期预后。

患者

2006 年在慕尼黑 CF 中心接受治疗的 370 名 CF 患者,平均年龄 17.1 岁(范围:0-48),根据 MI 病史进行分类。

方法

回顾性分析 MI 病史、年龄、肺功能以及铜绿假单胞菌的首次检出作为主要结局变量。

结果

我们确定了 60 名有 MI(所有患者的 16.2%)的患者,他们的平均年龄为 16.2 +/- 9 岁(0-41),与无 MI 的患者在年龄上没有差异(17.3 +/- 10;0-48),而 CF 诊断的平均年龄不同(0.4 与 21.8 个月,P < 0.001)。2006 年最佳用力呼气量(FEV%预计值)的横断面分析在 MI 患者(89 +/- 23%,17-134)和无 MI 患者(88 +/- 27%,21-148,P = 0.73)之间没有差异。使用超过 9000 次肺功能测试的 FEV1 值进行的纵向分析也显示出 FEV1 没有差异,尽管 MI 患者中铜绿假单胞菌的首次检出明显更早。

结论

MI 与住院、手术和铜绿假单胞菌的早期感染有关。然而,有或无 MI 的 CF 患者的长期预后是相同的。这一发现可能是由于 MI 患者 CF 的诊断更早,包括早期开始适当 CF 治疗的益处。

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