Kerem E, Corey M, Gold R, Levison H
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr. 1990 May;116(5):714-9. doi: 10.1016/s0022-3476(05)82653-8.
To evaluate the relationship between Pseudomonas aeruginosa colonization and the development of lung disease, we studied 895 patients who attended our cystic fibrosis clinic between 1975 and 1988. The prevalence of P. aeruginosa colonization was 82%. Patients who acquired P. aeruginosa in the first year of life had a similar 10-year survival rate (85%) to that in patients who were colonized between the ages of 1 and 7 years (87%), and to that in patients colonized after the age of 7 years (78%). One year before colonization, mean age, forced expiratory volume in 1 second (FEV1), forced vital capacity, and forced expiratory flow in the mid-expiratory phase were similar to those in a group of patients who remained free of P. aeruginosa. No significant change in pulmonary function variables could be demonstrated 1 year and 2 years after the colonization. The rate and duration of hospitalization did not increase in the years after P. aeruginosa colonization compared with the years before colonization. By the age of 7 years, the mean percentage of predicted FEV1 was lower by 10% in patients who were already colonized by P. aeruginosa compared with those who were not colonized (p less than 0.01). A similar reduction in FEV1 was observed at all ages from 7 to 35 years, but no precipitate rate of decline in FEV1 could be associated with P. aeruginosa colonization. We conclude that although P. aeruginosa colonization is associated with 10% lower lung function, it does not cause an immediate and rapid reduction, as has been previously reported. The clinical course and the pulmonary deterioration in cystic fibrosis after P. aeruginosa colonization is a gradual and variable process.
为了评估铜绿假单胞菌定植与肺部疾病发展之间的关系，我们研究了1975年至1988年间在我们囊性纤维化诊所就诊的895例患者。铜绿假单胞菌定植的患病率为82%。1岁时感染铜绿假单胞菌的患者10年生存率（85%）与1至7岁定植患者（87%）以及7岁后定植患者（78%）相似。在定植前一年，平均年龄、第一秒用力呼气量（FEV1）、用力肺活量和呼气中期用力呼气流量与一组未感染铜绿假单胞菌的患者相似。定植后1年和2年，肺功能变量无明显变化。与定植前几年相比，铜绿假单胞菌定植后几年的住院率和住院时间没有增加。到7岁时，已感染铜绿假单胞菌的患者预计FEV1的平均百分比比未感染患者低10%（p<0.01）。在7至35岁的所有年龄段都观察到FEV1有类似程度的下降，但FEV1的下降速度与铜绿假单胞菌定植无关。我们得出结论，虽然铜绿假单胞菌定植与肺功能降低10%有关，但它不会像先前报道的那样导致立即和快速的下降。铜绿假单胞菌定植后囊性纤维化的临床病程和肺部恶化是一个渐进且多变的过程。
