长期阿托伐他汀治疗对肺移植术后阿奇霉素预防患者慢性肺移植功能障碍发展的影响

Transplantation proceedings Pub Date : 2024-11-01 Epub Date: 2024-10-24 DOI:10.1016/j.transproceed.2024.10.015
Dan Zhang, Xiaoxing Wang, Wenwen Du, Pengmei Li
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引用次数: 0

摘要

目的评估长期阿托伐他汀(ATO)治疗对减轻受者炎症和免疫反应的影响,从而降低肺移植受者发生慢性肺移植功能障碍(CLAD)的风险。本研究旨在探讨阿托对总生存期、肺功能恢复的影响,以及阿奇霉素(AZI)预防治疗对炎症因素的影响:这项回顾性单中心研究纳入了2017年1月至2022年12月的肺移植受者。研究选择了肺移植术后存活超过1年、接受AZI预防治疗超过6个月的患者。结果测量包括AZI治疗后不同时间点的肺功能评估、全血细胞分析和炎症因子评估:结果:与未使用 ATO 的患者相比,长期 ATO 组的 CLAD 发生率明显较低(P = .011)。长期 ATO 治疗明显推迟了肺移植后 CLAD 的发病时间(850 天 vs. 630 天;P = .041),与非 ATO 组相比,患者在接受 AZI 治疗后 6 个月内的肺功能恢复明显增强。与 AZI 组相比,CLAD 患者的中性粒细胞水平下降,AZI + ATO 组的白细胞介素-6 浓度显著降低。AZI+ATO组患者的总生存率明显高于AZI组(P = .02):结论:在使用 AZI 预防后仍出现 CLAD 的病例中,长期 ATO 治疗可在短期内改善肺功能。它还能降低肺移植受者的炎症水平,提高总生存率。联合使用 AZI 和长期 ATO 治疗可能有利于预防 CLAD。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Long-Term Atorvastatin Therapy on the Development of Chronic Lung Allograft Dysfunction in Patients with Azithromycin Prophylaxis after Lung Transplantation.

Objective: To assess the impact of long-term atorvastatin (ATO) therapy on reducing recipient inflammation and immune response, thus lowering the risk of chronic lung allograft dysfunction (CLAD) in lung transplant recipients. This study aimed to investigate the effects of ATO on overall survival, lung function recovery, and its influence on inflammatory factors alongside azithromycin (AZI) prophylaxis.

Methods: This retrospective single-center study included lung transplant recipients from January 2017 to December 2022. Patients who survival >1 year after lung transplantation and who were receiving AZI prophylaxis for >6 months were selected. Outcome measures involved pulmonary function assessments at various time points after AZI treatment, complete blood cell analysis, and inflammatory factor evaluations.

Results: The incidence of CLAD was significantly lower in the long-term ATO group compared with those not on ATO (P = .011). Long-term ATO treatment significantly delayed CLAD onset after lung transplantation (850 days vs. 630 days; P = .041), with patients showing notably enhanced lung function recovery within 6 months of AZI therapy compared with the non-ATO group. Neutrophil levels decreased in patients with CLAD, and interleukin-6 concentrations significantly decreased in the AZI + ATO group compared with the AZI group. Overall patient survival was significantly better in the AZI+ATO group than in the AZI group (P = .02).

Conclusion: In cases where CLAD develops despite AZI prophylaxis, long-term ATO treatment may lead to short-term improvements in lung function. It could also decrease inflammation levels in lung transplant recipients and enhance overall survival. The combination of AZI and long-term ATO therapy may be beneficial for CLAD prevention.

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