Zuckerman Jonathan B, Hinton Alexandra C, Lahiri Thomas, Teneback Charlotte C, Jia Shijing, Mermis Joel, Polineni Deepika, Dasenbrook Elliott, Sadeghi Hossein, DiMango Emily, Dezube Rebecca, West Natalie E, Zemanick Edith T, Samya Z Nasr, Gifford Alex H
Maine Medical Center, Division of Pulmonary and Critical Care, Portland, Maine, USA.
Center for Outcomes and Research Evaluation, Maine Medical Center, Portland, Maine, USA.
Pediatr Pulmonol. 2025 Jan;60(1):e27487. doi: 10.1002/ppul.27487.
Although studies have examined changes in C-reactive protein (CRP) during pulmonary exacerbations (PEX) in people with cystic fibrosis (PwCF), few have evaluated CRP profiles across age groups. Here, we characterize age-related CRP responses to PEX treatment.
We measured CRP concentrations at the beginning and end of intravenous (IV) antibiotic therapy for PEX in 100 pediatric and 147 adult PwCF at 10 US CF Centers. We examined relationships between CRP and age, lung function, severity of PEX symptoms, and time to next PEX.
CRP measured at initiation of IV antibiotic treatment for PEX was higher in adults than children, median 8 mg/L (IQR 4, 32) versus 5 mg/L (IQR 2, 10), respectively (p < 0.001). There was a significant correlation between the initial CRP and drop in lung from baseline to the beginning of IV antibiotics in adults and children. Adjusted CRP dropped in response to PEX treatment more commonly in adults than in children (70% vs. 48%, respectively). The range of treatment responses was greater in adults, in those with higher symptom scores, and in those with more advanced lung disease. In adults elevated CRP at the end of treatment was also associated with incomplete recovery of lung function. CRP at the start of IV antibiotics was inversely related to time until the next PEX.
In children and adults with CF, CRP is increased at the initiation of IV antibiotic therapy for PEX and declines with treatment. The response is more pronounced in highly symptomatic adults with advanced lung disease.
尽管已有研究探讨了囊性纤维化患者（PwCF）肺部加重期（PEX）期间C反应蛋白（CRP）的变化，但很少有研究评估各年龄组的CRP情况。在此，我们描述与年龄相关的CRP对PEX治疗的反应。
我们在美国10个囊性纤维化中心测量了100名儿科PwCF患者和147名成年PwCF患者在接受PEX静脉（IV）抗生素治疗开始和结束时的CRP浓度。我们研究了CRP与年龄、肺功能、PEX症状严重程度以及下次PEX发生时间之间的关系。
PEX静脉抗生素治疗开始时测量的CRP在成年人中高于儿童，中位数分别为8mg/L（四分位间距IQR 4, 32）和5mg/L（IQR 2, 10）（p<0.001）。在成年人和儿童中，初始CRP与从基线到静脉抗生素治疗开始时肺功能下降之间存在显著相关性。与儿童相比，成年人中调整后的CRP因PEX治疗而下降更为常见（分别为70%和48%）。在症状评分较高、肺部疾病更严重的成年人中，治疗反应范围更大。在成年人中，治疗结束时CRP升高也与肺功能未完全恢复有关。静脉抗生素治疗开始时的CRP与下次PEX发生前的时间呈负相关。
在患有囊性纤维化的儿童和成年人中，PEX静脉抗生素治疗开始时CRP升高，且随治疗而下降。在症状严重、肺部疾病晚期的成年人中，这种反应更为明显。
