Loh Geoffrey, Ryaboy Ilya, Skabelund Andrew, French Alicia
Pulmonary/Critical Care, San Antonio Military Medical Center, Fort Sam Houston, Texas.
Internal Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas.
Clin Respir J. 2018 Apr;12(4):1545-1549. doi: 10.1111/crj.12703. Epub 2017 Sep 19.
Acute pulmonary exacerbations of cystic fibrosis (APECF) are a leading cause of morbidity and mortality among patients with cystic fibrosis (CF). APECF require frequent administration of antibiotics and subsequently lead to development of resistant organisms.
The aim of this study was to identify inflammatory markers that may be help identify need for antibiotics and exacerbation as well as predict risk of exacerbations.
A total of 17 patients were enrolled, and baseline erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin levels were obtained in addition to obtaining these levels during admissions for APECF.
A total of 28 APECF were recorded. ESR and CRP significantly increased during exacerbation (P < .01 for both). Procalcitonin did not increase during exacerbations. Baseline elevations in ESR and CRP increased risk of an exacerbation (RR = 2.3 and 4.5, respectively).
ESR and CRP are useful markers for CF exacerbations, as levels rise with exacerbations. Baseline elevations in ESR and CRP were noted to show an increased risk for CF exacerbations. Procalcitonin, in contrast, is not a useful inflammatory marker.
囊性纤维化急性肺部加重（APECF）是囊性纤维化（CF）患者发病和死亡的主要原因。APECF需要频繁使用抗生素，随后会导致耐药菌的产生。
本研究的目的是确定可能有助于识别对抗生素的需求和病情加重情况以及预测病情加重风险的炎症标志物。
共纳入17例患者，除了在APECF住院期间获取这些指标水平外，还获取了基线红细胞沉降率（ESR）、C反应蛋白（CRP）和降钙素原水平。
共记录了28次APECF发作。病情加重期间ESR和CRP显著升高（两者P均<0.01）。病情加重期间降钙素原未升高。ESR和CRP的基线升高增加了病情加重的风险（相对危险度分别为2.3和4.5）。
ESR和CRP是CF病情加重的有用标志物，因为其水平会随病情加重而升高。ESR和CRP的基线升高显示CF病情加重的风险增加。相比之下，降钙素原不是一个有用的炎症标志物。
