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卡塔尔以I1234V基因型为主的成年囊性纤维化患者的CT评分及其与肺功能和微生物学的相关性

CT score and correlation with lung function and microbiology of adult patients with cystic fibrosis with predominant I1234V genotype in Qatar.

作者信息

Thomas Merlin, Raja Mehak, Albakri Mutaz, Najim Mostafa, Chandra Prem, Allangawi Mona

机构信息

Department of Chest, Hamad General Hospital, Doha, Qatar.

Department of Medicine, Hamad General Hospital, Doha, Qatar.

出版信息

Qatar Med J. 2020 Apr 10;2020(1):4. doi: 10.5339/qmj.2020.4. eCollection 2020.

Abstract

Computed tomography (CT) features of cystic fibrosis (CF) lung disease can be objectively quantified using current CT scoring systems to assess the extent and severity of the disease. The aims of this study were to calculate the Santamaria CT scores in adult patients with CF with the predominant CFTR I1234V genotype, determine its reliability, and correlate these parameters with lung function, microbial colonization, compliance to treatment, and exacerbations. This retrospective observational study was conducted on adult patients with CF who were regularly followed up in the adult CF service at Qatar via CT scans that were taken not during an acute exacerbation. CT scans were scored using the Santamaria scoring system. Corresponding spirometry, microbiological data of sputum culture, and relevant clinical data were correlated with individual CT scores. Only 23 of the 31 patients underwent CT when not in an acute exacerbation and were included in the study analysis. A total of 20 (87%) patients had the I1234V genotype. There was good agreement between the two radiologists on the Santamaria CT scores with an intraclass correlation coefficient (ICC) value of 0.991. Bronchiectasis was the most consistent finding, followed by interlobular and intralobular septal thickening. Patients with poor lung function and frequent exacerbations had significantly higher CT scores ( = 0.015). The CT scores of patients colonized with were higher but nonsignificant ( = 0.20). The mean CT scores were significantly higher in patients who were noncompliant to regular treatment than in those who were compliant ( = 0.012). Santamaria CT scores comprise a reliable scoring system for adult patients with CF and can be used to determine the extent and severity of lung disease. colonization causes more structural lung damage than other common colonizing organisms. Noncompliance to treatment has a significant impact on the increasing severity of CF lung disease.

摘要

使用当前的CT评分系统可以客观地量化囊性纤维化(CF)肺病的计算机断层扫描(CT)特征,以评估疾病的范围和严重程度。本研究的目的是计算具有主要CFTR I1234V基因型的成年CF患者的圣玛丽亚CT评分,确定其可靠性,并将这些参数与肺功能、微生物定植、治疗依从性和病情加重情况相关联。这项回顾性观察性研究是对在卡塔尔成人CF服务中心定期随访的成年CF患者进行的,这些患者的CT扫描不是在急性加重期进行的。CT扫描采用圣玛丽亚评分系统进行评分。相应的肺功能测定、痰培养微生物学数据和相关临床数据与个体CT评分相关联。31例患者中只有23例在非急性加重期接受了CT检查并纳入研究分析。共有20例(87%)患者具有I1234V基因型。两位放射科医生对圣玛丽亚CT评分的一致性良好,组内相关系数(ICC)值为0.991。支气管扩张是最一致的表现,其次是小叶间和小叶内间隔增厚。肺功能差和频繁病情加重的患者CT评分显著更高(P = 0.015)。感染的患者CT评分更高,但无统计学意义(P = 0.20)。不遵守常规治疗的患者的平均CT评分显著高于遵守治疗的患者(P = 0.012)。圣玛丽亚CT评分是成年CF患者可靠的评分系统,可用于确定肺部疾病的范围和严重程度。感染比其他常见的定植微生物对肺部造成的结构损伤更大。不遵守治疗对CF肺病严重程度的增加有显著影响。

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