研究支气管镜检查和 BAL 在稳定期成人囊性纤维化患者中的安全性。

Safety of research bronchoscopy with BAL in stable adult patients with cystic fibrosis.

机构信息

Section of Pulmonary and Critical Care Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, United States of America.

Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America.

出版信息

PLoS One. 2021 Jan 22;16(1):e0245696. doi: 10.1371/journal.pone.0245696. eCollection 2021.

Abstract

Data on adverse events from research bronchoscopy with bronchoalveolar lavage (BAL) in patients with cystic fibrosis (CF) is lacking. As research bronchoscopy with BAL is useful for isolation of immune cells and investigation of CF lung microbiome, we sought to investigate the safety of bronchoscopy in adult patients with CF. Between November 2016 and September 2019, we performed research bronchoscopies on CF subjects (32) and control subjects (82). Control subjects were nonsmokers without respiratory disease. CF subjects had mild or moderate obstructive lung disease (FEV1 > 50% predicted) and no evidence of recent CF pulmonary exacerbation. There was no significant difference in the age or sex of each cohort. Neither group experienced life threatening adverse events. The number of adverse events was similar between CF and control subjects. The most common adverse events were sore throat and cough, which occurred at similar frequencies in control and CF subjects. Fever and headache occurred more frequently in CF subjects. However, the majority of fevers were seen in CF subjects with FEV1 values below 65% predicted. We found that CF subjects had similar adverse event profiles following research bronchoscopy compared to healthy subjects. While CF subjects had a higher rate of fevers, this adverse event occurred with greater frequency in CF subjects with lower FEV1. Our data demonstrate that research bronchoscopy with BAL is safe in CF subjects and that safety profile is improved if bronchoscopies are limited to subjects with an FEV1 > 65% predicted.

摘要

研究支气管镜肺泡灌洗(BAL)在囊性纤维化(CF)患者中不良事件的数据缺乏。由于研究支气管镜肺泡灌洗对于分离免疫细胞和研究 CF 肺部微生物组非常有用,我们试图研究 CF 成年患者支气管镜检查的安全性。

在 2016 年 11 月至 2019 年 9 月期间,我们对 CF 患者(32 例)和对照组患者(82 例)进行了研究性支气管镜检查。对照组为无呼吸系统疾病的不吸烟者。CF 患者患有轻度或中度阻塞性肺疾病(FEV1 > 50%预测值),且无近期 CF 肺部恶化的证据。每个队列的年龄和性别均无显著差异。两组均未发生危及生命的不良事件。CF 和对照组的不良事件数量相似。最常见的不良事件是咽痛和咳嗽,在对照组和 CF 患者中的发生频率相似。CF 患者中发热和头痛更为常见。然而,大多数发热发生在 FEV1 值低于 65%预测值的 CF 患者中。

我们发现,与健康受试者相比,CF 患者在接受研究性支气管镜检查后具有相似的不良事件谱。虽然 CF 患者发热的发生率更高,但这种不良事件在 FEV1 较低的 CF 患者中更为常见。我们的数据表明,CF 患者的支气管镜肺泡灌洗安全性良好,如果支气管镜检查仅限于 FEV1 > 65%预测值的患者,则安全性更好。

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