Cresta Federico, Naselli Aldo, Favilli Federica, Casciaro Rosaria
Cystic Fibrosis Centre, Pediatric Department, IRCCS G. Gaslini, Genova, Italy.
BMJ Case Rep. 2013 Apr 29;2013:bcr2013009042. doi: 10.1136/bcr-2013-009042.
The aim of the paper is to report the case of a boy affected by cystic fibrosis, with non-ABPA-related recurrent wheezing and frequent pulmonary exacerbation during childhood, who had been inhaling 7% NaCl+0.1% hyaluronic acid (HA) as a maintenance therapy. We reviewed patient database and, analysing a 7-year follow-up, considered pulmonary exacerbation, antibiotic and steroid courses, pulmonary function (forced expiratory volume in one second; FEV1) and microbiological data. After starting 7% NaCl+0.1% HA treatment, we observed a dramatic decrease of oral antibiotic need (0.55 courses/month during the pretreatment period against 0.10 courses/month in the treatment period), associated with a good initial recovery and a stability of FEV1. In our opinion this case could suggest an extended indication for inhaled 7% NaCl+0.1% HA use in CF, not only in patients who did not tolerate hypertonic saline, but also in patients with coexistent asthma-like symptoms.
本文旨在报告一名患有囊性纤维化的男孩的病例，该男孩在儿童期出现与非ABPA相关的反复喘息和频繁的肺部加重，一直在吸入7%氯化钠+0.1%透明质酸（HA）作为维持治疗。我们回顾了患者数据库，并通过分析7年的随访情况，考量了肺部加重情况、抗生素和类固醇疗程、肺功能（一秒用力呼气量；FEV1）以及微生物学数据。在开始7%氯化钠+0.1%HA治疗后，我们观察到口服抗生素需求显著减少（治疗前期为每月0.55个疗程，治疗期为每月0.10个疗程），同时伴有良好的初始恢复情况以及FEV1的稳定。我们认为，该病例可能提示在囊性纤维化患者中，吸入7%氯化钠+0.1%HA的适用范围有所扩大，不仅适用于不耐受高渗盐水的患者，也适用于伴有类似哮喘症状的患者。
