Dankert-Roelse Jeannette E, Mérelle Marieke E
Department of Pediatrics, Pediatric Pulmonology, Vrije Universiteit Medical Centre, Amsterdam, the Netherlands.
J Pediatr. 2005 Sep;147(3 Suppl):S15-20. doi: 10.1016/j.jpeds.2005.08.009.
We reviewed the published results of European prospective cohort and controlled studies and 1 randomized controlled study to assess whether newborn screening (NBS) for cystic fibrosis (CF) leads to an improved prognosis. We used long-term survival, early mortality, nutritional and pulmonary status, and the number of hospital admissions as outcome measures. Effects on reproductive behavior of the parents and relatives were also assessed. In 2 studies, a similar trend for improved long-term survival rate of the screened cohort was observed, whereas in 2 other studies CF NBS appeared to prevent CF-related deaths in infancy and early childhood. Screened patients born in the last 2 decades showed normal growth for height and weight from infancy until late childhood. In most studies, patients who were screened were found to have less lung damage than their non-screened peers. CF NBS significantly reduced the number of affected children who ever required hospitalization. In Brittany, France, a reduction of 15.7% in CF prevalence at birth was attributed to the introduction of a NBS program for CF. We conclude that there is accumulating evidence that CF NBS prevents early CF-related deaths and leads to a substantial and prolonged health gain for patients with CF.
我们回顾了欧洲前瞻性队列研究、对照研究以及1项随机对照研究已发表的结果,以评估囊性纤维化(CF)新生儿筛查是否能改善预后。我们将长期生存率、早期死亡率、营养和肺部状况以及住院次数作为结局指标。我们还评估了对父母及亲属生殖行为的影响。在2项研究中,观察到筛查队列的长期生存率有类似的改善趋势,而在另外2项研究中,CF新生儿筛查似乎可预防婴儿期和儿童早期与CF相关的死亡。过去20年出生的接受筛查的患者从婴儿期到儿童晚期身高和体重增长正常。在大多数研究中,发现接受筛查的患者肺部损伤比未接受筛查的同龄人少。CF新生儿筛查显著减少了需要住院治疗的患病儿童数量。在法国布列塔尼,出生时CF患病率降低了15.7%,这归因于CF新生儿筛查项目的引入。我们得出结论,越来越多的证据表明,CF新生儿筛查可预防早期与CF相关的死亡,并为CF患者带来显著且持久的健康益处。