Aspergillus and progression of lung disease in children with cystic fibrosis

医学 囊性纤维化 支气管扩张 支气管肺泡灌洗 空气滞留 肺功能测试 内科学 呼吸道疾病 人口 胃肠病学 曲霉 病理 植物 生物 环境卫生
作者
Sabariah Noor Harun,Claire Wainwright,Keith Grimwood,Stefanie Hennig
出处
期刊:Thorax [BMJ]
卷期号:74 (2): 125-131 被引量:33
标识
DOI:10.1136/thoraxjnl-2018-211550
摘要

The impact of Aspergillus on lung disease in young children with cystic fibrosis is uncertain.To determine if positive respiratory cultures of Aspergillus species are associated with: (1) increased structural lung injury at age 5 years; (2) accelerated lung function decline between ages 5 years and 14 years and (3) to identify explanatory variables.A cross-sectional analysis of association between Aspergillus positive bronchoalveolar lavage (BAL) cultures and chest high-resolution CT (HRCT) scan findings at age 5 years in subjects from the Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) study was performed. A non-linear mixed-effects disease progression model was developed using FEV1% predicted measurements at age 5 years from the ACFBAL study and at ages 6-14 years for these subjects from the Australian Cystic Fibrosis Data Registry.Positive Aspergillus BAL cultures at age 5 years were significantly associated with increased HRCT scores for air trapping (OR 5.53, 95% CI 2.35 to 10.82). However, positive Aspergillus cultures were not associated with either FEV1% predicted at age 5 years or FEV1% predicted by age following adjustment for body mass index z-score and hospitalisation secondary to pulmonary exacerbations. Lung function demonstrated a non-linear decline in this population.In children with cystic fibrosis, positive Aspergillus BAL cultures at age 5 years were associated contemporaneously with air trapping but not bronchiectasis. However, no association was observed between positive Aspergillus BAL cultures on FEV1% predicted at age 5 years or with lung function decline between ages 5 years and 14 years.

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