Wang E E, Prober C G, Manson B, Corey M, Levison H
N Engl J Med. 1984 Dec 27;311(26):1653-8. doi: 10.1056/NEJM198412273112602.
In a two-year prospective study, we examined the effect of respiratory viral infections on pulmonary function in 49 patients with cystic fibrosis (mean age, 13.7 years). Nineteen normal siblings (mean age, 14) served as controls. Subjects were assessed quarterly and at the time of any respiratory illness. Each assessment included nasal washes for viral isolation and blood drawing for respiratory viral serologic studies. Pulmonary-function tests were performed at least twice yearly. Respiratory illnesses were reported significantly more often in the patients (3.7 per year) than in the normal siblings (1.7 per year), although the frequency of proved viral infections (1.67 per year) was identical. In the patients with cystic fibrosis significant correlations (P less than 0.0001) were found between the annual incidence of viral infections and every measure of disease progression in the two-year period, including the rate of decline of the Shwachman score (r = 0.71), the percentage of ideal weight for height (r = 0.80), the forced vital capacity (r = 0.85), the forced expiratory volume in the first second (r = 0.84), the forced midexpiratory flow rate (r = 0.68), and the frequency (r = 0.53) and duration (r = 0.84) of hospitalizations for respiratory exacerbations. We conclude that frequency of viral respiratory infections is closely associated with pulmonary deterioration in patients with cystic fibrosis.
在一项为期两年的前瞻性研究中，我们检测了呼吸道病毒感染对49例囊性纤维化患者（平均年龄13.7岁）肺功能的影响。19名正常同胞（平均年龄14岁）作为对照。每季度以及在出现任何呼吸道疾病时对受试者进行评估。每次评估包括采集鼻洗液进行病毒分离以及采集血液进行呼吸道病毒血清学研究。每年至少进行两次肺功能测试。患者呼吸道疾病的报告频率（每年3.7次）显著高于正常同胞（每年1.7次），不过确诊的病毒感染频率（每年1.67次）是相同的。在囊性纤维化患者中，发现病毒感染的年发病率与两年内疾病进展的各项指标之间存在显著相关性（P<0.0001），这些指标包括施瓦克曼评分的下降率（r=0.71）、身高理想体重百分比（r=0.80）、用力肺活量（r=0.85）、第1秒用力呼气量（r=0.84）、用力呼气中期流速（r=0.68）以及因呼吸道病情加重住院的频率（r=0.53）和持续时间（r=0.84）。我们得出结论，病毒性呼吸道感染的频率与囊性纤维化患者的肺部恶化密切相关。
