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吸入性黏菌素在非囊性纤维化支气管扩张症成人患者中的清除作用。

Eradication of with inhaled colistin in adults with non-cystic fibrosis bronchiectasis.

机构信息

1 Department of Pneumology, Hospital Universitario A Coruña, A Coruña, Spain.

2 Department of Health Sciences, School of Nursing and Pediatry, University of Coruña, Spain.

出版信息

Chron Respir Dis. 2019 Jan-Dec;16:1479973119872513. doi: 10.1177/1479973119872513.

Abstract

The persistent isolation of in the airways of non-cystic fibrosis bronchiectasis (NCFB) patients is associated with a worsening of the symptoms, increase of exacerbations, poor quality of life and functional impairment. The objective of this study was the analysis of the eradication rate of in the sputum of patients with NCFB treated with inhaled colistin and the effects of the treatment in the exacerbations. This was a prospective, cohort, study of 67 NCFB patients treated with inhaled colistin at the Hospital of A Coruña (Spain). We recorded dyspnoea, exacerbations, lung function and sputum cultures of in the patients. The mean age of the patients was 67.25 ± 14.6 years (59.7% male). The percentages of eradication of in sputum at 3, 6, 9 and 12 months were 61.2%, 50.7%, 43.3% and 40.3%, respectively. We observed a significant decrease in exacerbations after 1 year of colistin treatment (1.98 ± 3.62) versus the previous year (3.40 ± 4.21, < 0.001). We conclude that treatment with inhaled colistin in patients with NCFB and in sputum can achieve high rates of eradication even in patients with several previous positive cultures, as well as a significant decrease of exacerbations and hospital admissions.

摘要

在非囊性纤维化性支气管扩张症(NCFB)患者的气道中持续分离出铜绿假单胞菌与症状恶化、加重频率增加、生活质量下降和功能障碍有关。本研究的目的是分析吸入性黏菌素治疗 NCFB 患者痰中铜绿假单胞菌的清除率以及治疗对加重的影响。这是一项在西班牙拉科鲁尼亚医院进行的前瞻性队列研究,共纳入 67 例接受吸入性黏菌素治疗的 NCFB 患者。我们记录了患者的呼吸困难、加重情况、肺功能和痰培养的铜绿假单胞菌。患者的平均年龄为 67.25 ± 14.6 岁(59.7%为男性)。3、6、9 和 12 个月时痰中铜绿假单胞菌清除率分别为 61.2%、50.7%、43.3%和 40.3%。我们观察到黏菌素治疗 1 年后,加重的发生率显著下降(1.98 ± 3.62)与前一年(3.40 ± 4.21,<0.001)相比。我们的结论是,在 NCFB 患者中,即使在多次痰培养阳性的患者中,使用吸入性黏菌素治疗可实现较高的清除率,同时显著减少加重和住院次数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2cb/6724485/9f9a5046df5f/10.1177_1479973119872513-fig1.jpg

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