METHODS: This multicenter, case-control, observational, retrospective study included two groups of patients with CF: a case group (patients with persistent atelectasis who were followed-up at least for 2 years) and a control group (patients without atelectasis matched 1:1 by sex and age [±3 years]). We recorded demographic data, lung function test results, pulmonary complications, comorbidities, treatments (including bronchoscopies, surgery and transplantation), and deaths.
RESULTS: Each group included 55 patients (case group: 20 men, mean age 25.4 ± 10.4 years; control group: 20 men, mean age 26.1 ± 11.4 years). Bronchoscopy did not lead to clinicoradiological improvement. Allergic bronchopulmonary aspergillosis (ABPA) was more frequent in the case group. Patients in the case group more frequently used inhaled steroids, their pre-atelectasis lung function was statistically worse, and they had more exacerbations during follow-up.
CONCLUSIONS: Moderate-to-severe pulmonary disease and ABPA can favor atelectasis. Pulmonary atelectasis can be a poor prognostic factor in CF because it increases exacerbations. Despite our results, we recommend enhancing treatment, including bronchoscopy, to prevent persistent atelectasis.
方法:这个多中心,病例控制,观察,回顾性研究包括两组CF患者:病例组(持续肺不张患者,随访至少2年)和对照组(无肺不张患者,性别和年龄匹配1:1[±3岁]).我们记录了人口统计数据,肺功能检查结果,肺部并发症,合并症,治疗(包括支气管镜检查,手术和移植),和死亡。
结果:每组包括55名患者(病例组:20名男性,平均年龄25.4±10.4岁;对照组:20名男性,平均年龄26.1±11.4岁)。支气管镜检查未导致临床放射学改善。变应性支气管肺曲霉病(ABPA)在病例组中更为常见。病例组患者更经常使用吸入类固醇,他们的肺不张前肺功能在统计学上较差,他们在随访期间有更多的恶化。
结论:中重度肺部疾病和ABPA有利于肺不张。肺不张可能是CF的不良预后因素,因为它会增加恶化。尽管我们的结果,我们建议加强治疗,包括支气管镜检查,以防止持续性肺不张。