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[原发性纤毛运动障碍的管理]

[Management of Primary Ciliary Dyskinesia].

作者信息

Raidt J, Brillault J, Brinkmann F, Jung A, Koerner-Rettberg C, Koitschev A, Linz-Keul H, Nüßlein T, Ringshausen F C, Röhmel J, Rosewich M, Werner C, Omran H

机构信息

Klinik für Kinder- und Jugendmedizin, Allgemeine Pädiatrie, Universitätsklinikum Münster, Münster.

Kartagener Syndrom & Primäre Ciliäre Dyskinesie e. V., Herbolzheim.

出版信息

Pneumologie. 2020 Nov;74(11):750-765. doi: 10.1055/a-1235-1520. Epub 2020 Sep 25.

Abstract

Primary Ciliary Dyskinesia (PCD, MIM 242650) is a rare, hereditary multiorgan disease characterized by malfunction of motile cilia. Hallmark symptom is a chronic airway infection due to mucostasis leading to irreversible lung damage that may progress to respiratory failure. There is no cure for this genetic disease and evidence-based treatment is limited. Until recently, there were no randomized controlled trials performed in PCD, but this year, data of the first placebo-controlled trial on pharmacotherapy in PCD were published. This cornerstone in the management of PCD was decisive for reviewing currently used treatment strategies. This article is a consensus of patient representatives and clinicians, which are highly experienced in care of PCD-patients and provides an overview of the management of PCD. Treatments are mainly based on expert opinions, personal experiences, or are deduced from other lung diseases, notably cystic fibrosis (CF), COPD or bronchiectasis. Most strategies focus on routine airway clearance and treatment of recurrent respiratory tract infections. Non-respiratory symptoms are treated organ specific. To generate further evidence-based knowledge, other projects are under way, e. g. the International PCD-Registry. Participating in patient registries facilitates access to clinical and research studies and strengthens networks between centers. In addition, knowledge of genotype-specific course of the disease will offer the opportunity to further improve and individualize patient care.

摘要

原发性纤毛运动障碍(PCD,MIM 242650)是一种罕见的遗传性多器官疾病,其特征为运动性纤毛功能异常。标志性症状是由于黏液停滞导致慢性气道感染,进而造成不可逆的肺损伤,可能发展为呼吸衰竭。这种遗传性疾病无法治愈,循证治疗也很有限。直到最近,PCD领域都没有进行过随机对照试验,但今年,首个PCD药物治疗的安慰剂对照试验数据已发表。PCD管理中的这一基石对于审视当前使用的治疗策略具有决定性意义。本文是患者代表和临床医生的共识,他们在PCD患者护理方面经验丰富,对PCD的管理进行了概述。治疗主要基于专家意见、个人经验,或从其他肺部疾病(尤其是囊性纤维化(CF)、慢性阻塞性肺疾病(COPD)或支气管扩张症)推导而来。大多数策略侧重于常规气道清理和复发性呼吸道感染的治疗。非呼吸道症状则按器官特异性进行治疗。为了产生更多基于证据的知识,其他项目正在开展,例如国际PCD注册研究。参与患者注册研究有助于参与临床和研究,加强各中心之间的网络联系。此外,了解疾病的基因型特异性病程将为进一步改善和个性化患者护理提供机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/493a/7671756/ef4a0ffc3caf/10-1055-a-1235-1520-i089pn1.jpg

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