革兰氏阴性感染在囊性纤维化综合治疗中的应用

Q4 Medicine
А.Ю.Воронкова, Е.К.Жекайте, В.Д.Шерман, Е.Л.Амелина, А.В.Орлов, О.В.Усачева, В.П.Тараканова, Л.В.Смирнова, Е.В.Паснова, Н.Д.Одинаева, Е.И.Кондратьева, A. Voronkova, E. Zhekaite, V. Sherman, E. Amelina, Alexander V. Orlov, O. V. Usacheva, V. Tarakanova, Larisa V. Smirnova, E. Pasnova, N. D. Odinaeva, E. Kondratyeva
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To investigate the safety and efficacy of inhaled administration of sodium colistimethate (Colimistin®). Methods. The study enrolled 42 patients (27 patients aged 5 to 17 years and 15 patients over 18 years) with an established diagnosis of cystic fibrosis, 38 with monoculture of P. aeruginosa or various associations, 4 with Achromobacter spp. culture. Microbial status, external respiratory function, nutritional status, assessment of well-being, adverse reactions, exacerbations, and use of antibiotic therapy during colimistin inhalations were recorded in all patients at baseline and at 3 months. Results. A significant improvement in nutritional status in terms of weight (p < 0.007) and height (p < 0.001) was shown in the general patient group and the children’s group. In the group of children, there was a significant increase in weight (p < 0.034) and height (p < 0.0001). 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引用次数: 0

摘要

慢性肺部感染是囊性纤维化中粘膜纤毛清除过程紊乱的结果。对于大多数囊性纤维化患者,慢性肺部感染与预后不良有关。慢性铜绿假单胞菌感染对肺功能进行性恶化和营养状况的影响已经确定。及时和有效的抗生素治疗旨在根除或控制革兰氏阴性菌群影响寿命和生活质量。研究的目的。探讨吸入给药大肠杆菌素(Colimistin®)的安全性和有效性。方法。该研究纳入了42例确诊为囊性纤维化的患者(27例5 - 17岁,15例18岁以上),38例单一培养铜绿假单胞菌或各种关联,4例无色杆菌培养。在基线和3个月时记录所有患者在吸入粘菌素期间的微生物状况、外部呼吸功能、营养状况、健康评估、不良反应、恶化和抗生素治疗的使用情况。结果。普通患者组和儿童组的营养状况在体重(p < 0.007)和身高(p < 0.001)方面均有显著改善。在儿童组中,体重(p < 0.034)和身高(p < 0.0001)显著增加。在年龄大于18岁的患者组中,治疗后3个月体重和BMI均有显著升高(p < 0.045)。FVC和FEV1无明显改善。一般患者组和儿童组的幸福感评估显示治疗效果(p < 0.001)。成人患者组无统计学差异(p < 0.067)。两名患者在治疗开始时因不良反应退出研究。结论。大肠杆菌酸钠对单一培养的铜绿假单胞菌和无色杆菌引起的支气管肺感染显示出有效性和安全性,可能推荐用于患有囊性纤维化的儿童和成人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Therapy of gram-negative infection in the complex treatment of cystic fibrosis
Chronic lung infections are a consequence of the disturbance of mucociliary clearance process in cystic fibrosis. For most patients with cystic fibrosis, chronic lung infection is associated with a poor prognosis. The impact of chronic Pseudomonas aeruginosa infection on progressive deterioration of lung function and nutritional status has been established. Timely and effective antibiotic therapy aimed at eradication or control of gram-negative flora affects the duration and quality of life. The purpose of the study. To investigate the safety and efficacy of inhaled administration of sodium colistimethate (Colimistin®). Methods. The study enrolled 42 patients (27 patients aged 5 to 17 years and 15 patients over 18 years) with an established diagnosis of cystic fibrosis, 38 with monoculture of P. aeruginosa or various associations, 4 with Achromobacter spp. culture. Microbial status, external respiratory function, nutritional status, assessment of well-being, adverse reactions, exacerbations, and use of antibiotic therapy during colimistin inhalations were recorded in all patients at baseline and at 3 months. Results. A significant improvement in nutritional status in terms of weight (p < 0.007) and height (p < 0.001) was shown in the general patient group and the children’s group. In the group of children, there was a significant increase in weight (p < 0.034) and height (p < 0.0001). In the group of patients older than 18 years, there was a significant increase in weight (p < 0.045) and BMI three months after therapy (p < 0.013). There were no significant improvements in FVC and FEV1. The treatment efficacy was shown by the assessment of well-being in the general patient group (p < 0.001) and in the children’s group (p < 0.002). No significant difference was found in the adult patient group (p < 0.067). Two patients dropped out of the study due to ADR at the start of therapy. Conclusion. Sodium colistimethate showed efficacy and safety in bronchopulmonary infections caused by P. aeruginosa in monoculture and in association with Achromobacter spp. and may be recommended for use in children and adults with cystic fibrosis.
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来源期刊
Pulmonologiya
Pulmonologiya Medicine-Pulmonary and Respiratory Medicine
CiteScore
1.40
自引率
0.00%
发文量
70
期刊介绍: The aim of this journal is to state a scientific position of the Russian Respiratory Society (RRS) on diagnosis and treatment of respiratory diseases based on recent evidence-based clinical trial publications and international consensuses. The most important tasks of the journal are: -improvement proficiency qualifications of respiratory specialists; -education in pulmonology; -prompt publication of original studies on diagnosis and treatment of respiratory diseases; -sharing clinical experience and information about pulmonology service organization in different regions of Russia; -information on current protocols, standards and recommendations of international respiratory societies; -discussion and consequent publication Russian consensus documents and announcement of RRS activities; -publication and comments of regulatory documents of Russian Ministry of Health; -historical review of Russian pulmonology development. The scientific concept of the journal includes publication of current evidence-based studies on respiratory medicine and their discussion with the participation of Russian and foreign experts and development of national consensus documents on respiratory medicine. Russian and foreign respiratory specialists including pneumologists, TB specialists, thoracic surgeons, allergists, clinical immunologists, pediatricians, oncologists, physiologists, and therapeutists are invited to publish article in the journal.
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