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囊性纤维化患者表型和基因型特征与疾病严重程度的关系。

Association between phenotypic and genotypic characteristics and disease severity in individuals with cystic fibrosis.

机构信息

Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.

出版信息

Rev Paul Pediatr. 2022 Sep 9;41:e2021286. doi: 10.1590/1984-0462/2023/41/2021286. eCollection 2022.

Abstract

OBJECTIVE

To analyze the association between phenotypic and genotypic characteristics and disease severity in individuals with cystic fibrosis treated at a reference center in Minas Gerais, Brazil.

METHODS

This is a retrospective study that collected clinical and laboratory data, respiratory and gastrointestinal manifestations, type of treatment, Shwachman-Kulczycki score, and mutations from the patients' medical records.

RESULTS

The sample included 50 participants aged one to 33 years, 50% of whom were female. Out of the one hundred alleles of the Cystic Fibrosis Transmembrane Conductance Regulator gene, the most prevalent mutations were DeltaF508 (45%) and S4X (18%). Mutation groups were only associated with pancreatic insufficiency (p=0.013) and not with disease severity (p=0.073). The latter presented an association with colonization by Pseudomonas aeruginosa and Staphylococcus aureus (p=0.007) and with underweight (p=0.036). Death was associated with age at diagnosis (p=0.016), respiratory symptomatology (p=0.013), colonization (p=0.024), underweight (p=0.017), and hospitalization (p=0.003).

CONCLUSIONS

We could identify the association of mutations with pancreatic insufficiency; the association of Staphylococcus aureus colonization and underweight with disease severity; and the lack of association between mutations and disease severity. Environmental factors should be investigated more thoroughly since they seem to have an important effect on disease severity.

摘要

目的

分析巴西米纳斯吉拉斯州参考中心治疗的囊性纤维化个体的表型和基因型特征与疾病严重程度之间的关系。

方法

这是一项回顾性研究,收集了患者病历中的临床和实验室数据、呼吸和胃肠道表现、治疗类型、Shwachman-Kulczycki 评分和突变。

结果

该样本包括 50 名年龄在 1 至 33 岁之间的参与者,其中 50%为女性。在囊性纤维化跨膜电导调节因子基因的一百个等位基因中,最常见的突变是 DeltaF508(45%)和 S4X(18%)。突变组仅与胰腺功能不全相关(p=0.013),与疾病严重程度无关(p=0.073)。后者与铜绿假单胞菌和金黄色葡萄球菌定植(p=0.007)和体重不足(p=0.036)有关。死亡与诊断时的年龄(p=0.016)、呼吸症状(p=0.013)、定植(p=0.024)、体重不足(p=0.017)和住院(p=0.003)有关。

结论

我们可以确定突变与胰腺功能不全之间的关联;金黄色葡萄球菌定植和体重不足与疾病严重程度之间的关联;以及突变与疾病严重程度之间缺乏关联。应更深入地研究环境因素,因为它们似乎对疾病严重程度有重要影响。

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