Smădeanu Roxna, Moşescu Simona, Zăpucioiu Carmen, Orăşeanu Dumitru
Pneumologia. 2016 Oct-Dec;65(4):201-6.
Pseudomonas aeruginosa (Pa) is the most important pathogen affecting the prognosis of patients with cystic fibrosis (CF). Distinguishing the correlations associated with PA infection may change the way in which investigation and therapeutic plans are approached. This study aims to evaluate the correlations between various factors such as age at diagnosis, nutritional status, homozygous status of delF508 mutation, the number of exacerbations per year, imagistic modifications, the presence of chronic infection with Staphylococcus aureus, serum levels of total immunoglobulins G (IgG) and gammaglobulins and ventilation parameters - forced vital capacity (FVC) and one-second forced expired volume (FEV1) and their association with Pa infection.
The associations between the analyzed parameters have been made by logistic regression; the comparisons between means of continuous variables were performed using Studen t-test; the variables distribution was tested using chi-square-test; and correlations between variables were assessed using Pearson coefficient.
The mean age at the acquisition of Pa was 5.26 (±5.3 years). Of the 50 patients included in the study, 21 acquired the Pa infection having the median age of primo-infection of 3 years. The study identified a greater number of exacerbations per year in those infected with Pa (2.71 compared to 1.38 exacerbations per year; p=0.002); the increase of radiological score with 1 unit associated with an increased risk of infection with Pa (OR 1.31; 95% CI 1.10-1.56;p=0.002), the mean Brasfield radiologic score is lower for uninfected children (6.9 vs. 11 points, p=0.001); increasing the degree of bronchiectasis associated with Pa infection (OR 3.75;CI 1.77-7.96;p=0.001); gammaglobulin (15.91 vs. 19.42%;p=0.01) or immunoglobulin G values (IgG) (9.8 vs. 11.9 g/L;p=0.05) were higher for those infected.
The increased number of exacerbations per year, the severity of imagistic modifications, and IgG and gammaglobulin values are associated with Pa infection. Tracking these parameters guides the therapeutic conduct.
铜绿假单胞菌（Pa）是影响囊性纤维化（CF）患者预后的最重要病原体。区分与PA感染相关的关联可能会改变研究和治疗方案的制定方式。本研究旨在评估各种因素之间的相关性，如诊断时的年龄、营养状况、delF508突变的纯合状态、每年发作的次数、影像学改变、金黄色葡萄球菌慢性感染的存在、血清总免疫球蛋白G（IgG）和丙种球蛋白水平以及通气参数——用力肺活量（FVC）和一秒用力呼气量（FEV1），以及它们与Pa感染的关联。
通过逻辑回归分析所分析参数之间的关联；使用Student检验对连续变量的均值进行比较；使用卡方检验检验变量分布；使用Pearson系数评估变量之间的相关性。
获得Pa感染的平均年龄为5.26（±5.3岁）。在纳入研究的50名患者中，21名获得了Pa感染，初次感染的中位年龄为3岁。该研究发现，感染Pa的患者每年发作次数更多（分别为每年2.71次和1.38次；p = 0.002）；放射学评分每增加1个单位与Pa感染风险增加相关（比值比1.31；95%置信区间1.10 - 1.56；p = 0.002），未感染儿童的平均布拉斯菲尔德放射学评分较低（6.9分对11分，p = 0.001）；支气管扩张程度增加与Pa感染相关（比值比3.75；置信区间1.77 - 7.96；p = 0.001）；感染患者的丙种球蛋白（15.91%对19.42%；p = 0.01）或免疫球蛋白G值（IgG）（9.8 g/L对11.9 g/L；p = 0.05）更高。
每年发作次数增加、影像学改变的严重程度以及IgG和丙种球蛋白值与Pa感染相关。追踪这些参数有助于指导治疗行为。
