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来自真实世界注册数据的杜氏肌营养不良症呼吸特征

Duchenne muscular dystrophy respiratory profiles from real world registry data.

作者信息

Hnaini Mona, Downs Matt, Miller Michael R, Campbell Craig, St-Laurent Aaron

机构信息

Department of Pediatrics, Schulich School of Medicine & Dentistry Western University, London, Ontario, Canada.

Department of Pediatrics, Children's Hospital London Health Sciences Centre, London, Ontario, Canada.

出版信息

Pediatr Pulmonol. 2023 Oct;58(10):2725-2732. doi: 10.1002/ppul.26554. Epub 2023 Aug 4.

Abstract

INTRODUCTION

Understanding real-world profiles from neuromuscular databases is helpful for optimizing clinical care and planning research studies. The Canadian Neuromuscular Disease Registry (CNDR) has respiratory data from a population of boys with Duchenne Muscular Dystrophy (DMD).

OBJECTIVES

To describe cross-sectional respiratory profiles from a national DMD real-world dataset. To explore the relationship between forced vital capacity percent predicted (FVC%) and disease severity parameters: scoliosis, ambulation and ventilation status.

METHODS

Descriptive statistics summarized the respiratory profiles. The CNDR registry enrolls and collects DMD clinic data from 36 Canadian centers.

RESULTS

There were 414 participants enrolled. The age ranged from 2 to 36 years old. Pulmonary function test data were available for 323 participants. The use of ventilatory support was seen in a significant proportion (19.5%) of subjects by age 14-16 years and was used by the majority (69.2%) by age 20-22 years. FVC% declined at a rate of 3.19% per year with every 1-year increase in age. FVC% declined annually by 2.47% in nonambulatory participants versus by 0.96% in ambulatory participants. FVC% did not significantly change over age with the presence of scoliosis or use of ventilatory technology.

CONCLUSIONS

The data from this large cohort are valuable for understanding real-world patterns of clinical care and disease progression. There is a significant association between the loss of ambulation and the rate of FVC% decline. Further longitudinal studies are needed to better understand the impact of disease parameters on pulmonary function decline and the need for ventilatory support.

摘要

引言

从神经肌肉数据库了解真实世界的概况有助于优化临床护理和规划研究。加拿大神经肌肉疾病登记处(CNDR)拥有来自杜氏肌营养不良症(DMD)男孩群体的呼吸数据。

目的

描述来自全国DMD真实世界数据集的横断面呼吸概况。探讨预测的用力肺活量百分比(FVC%)与疾病严重程度参数:脊柱侧弯、行走能力和通气状态之间的关系。

方法

描述性统计总结了呼吸概况。CNDR登记处从36个加拿大中心登记并收集DMD临床数据。

结果

共有414名参与者登记。年龄范围为2至36岁。323名参与者有肺功能测试数据。到14 - 16岁时,相当比例(19.5%)的受试者使用了通气支持,到20 - 22岁时,大多数(69.2%)受试者使用了通气支持。随着年龄每增加1岁,FVC%以每年3.19%的速度下降。非行走能力参与者的FVC%每年下降2.47%,而行走能力参与者的FVC%每年下降0.96%。在存在脊柱侧弯或使用通气技术的情况下,FVC%随年龄没有显著变化。

结论

这个大型队列的数据对于理解临床护理和疾病进展的真实世界模式很有价值。行走能力丧失与FVC%下降率之间存在显著关联。需要进一步的纵向研究来更好地理解疾病参数对肺功能下降的影响以及对通气支持的需求。

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