早期呼吸道病毒感染与囊性纤维化婴儿结构性肺病的关系。
Association between early respiratory viral infections and structural lung disease in infants with cystic fibrosis.
机构信息
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Pediatrics, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, USA.
出版信息
J Cyst Fibros. 2022 Nov;21(6):1020-1026. doi: 10.1016/j.jcf.2022.04.014. Epub 2022 May 4.
BACKGROUND
Infants with cystic fibrosis (CF) develop structural lung disease early in life, and viral infections are associated with progressive lung disease. We hypothesized that the presence of respiratory viruses would be associated with structural lung disease on computed tomography (CT) of the chest in infants with CF.
METHODS
Infants with CF were enrolled before 4 months of age. Multiplex PCR assays were performed on nasal swabs to detect respiratory viruses during routine visits and when symptomatic. Participants underwent CT imaging at approximately 12 months of age. Associations between Perth-Rotterdam Annotated Grid Morphometric Analysis for CF (PRAGMA-CF) CT scores and respiratory viruses and symptoms were assessed with Spearman correlation coefficients.
RESULTS
Sixty infants were included for analysis. Human rhinovirus was the most common virus detected, on 28% of tested nasal swabs and in 85% of participants. The median (IQR) extent of lung fields that was healthy based on PRAGMA-CF was 98.7 (0.8)%. There were no associations between PRAGMA-CF and age at first virus, or detection of any virus, including rhinovirus, respiratory syncytial virus, or parainfluenza. The extent of airway wall thickening was associated with ever having wheezed (ρ = 0.31, p = 0.02) and number of encounters with cough (ρ = 0.25, p = 0.0495).
CONCLUSIONS
Infants with CF had minimal structural lung disease. We did not find an association between respiratory viruses and CT abnormalities. Wheezing and frequency of cough were associated with early structural changes.
背景
患有囊性纤维化（CF）的婴儿在生命早期就会出现结构性肺病，病毒感染与进行性肺病有关。我们假设呼吸道病毒的存在与 CF 婴儿胸部计算机断层扫描（CT）的结构性肺病有关。
方法
在婴儿 4 个月之前，招募 CF 婴儿。在常规就诊时和出现症状时，通过鼻拭子进行多重 PCR 检测以检测呼吸道病毒。大约在 12 个月大时，参与者接受 CT 成像。使用 Spearman 相关系数评估 Perth-Rotterdam 注释网格形态计量分析 CF（PRAGMA-CF）CT 评分与呼吸道病毒和症状之间的关联。
结果
共纳入 60 名婴儿进行分析。人鼻病毒是最常见的病毒，在 28%的鼻拭子和 85%的参与者中均有检测到。基于 PRAGMA-CF，肺部健康区域的中位数（IQR）为 98.7（0.8）%。PRAGMA-CF 与首次病毒感染的年龄或任何病毒（包括鼻病毒、呼吸道合胞病毒或副流感病毒）的检测之间均无关联。气道壁增厚的程度与曾经喘息（ρ=0.31，p=0.02）和咳嗽次数（ρ=0.25，p=0.0495）有关。
结论
患有 CF 的婴儿结构性肺病的程度较小。我们没有发现呼吸道病毒与 CT 异常之间存在关联。喘息和咳嗽频率与早期结构变化有关。
Zotero 插件