Department of Paediatrics, Aarhus University Hospital Skejby, DK-8200 Aarhus N, Denmark.
Pediatr Pulmonol. 2010 Oct;45(10):959-65. doi: 10.1002/ppul.21265.
To explore whether gender differences in the Scandinavian Cystic Fibrosis (CF) patients exist in the areas of key clinical parameters, complications, and medication.
Cross-sectional data on 890 (416 female) pancreatic insufficient CF patients were evaluated regarding chronic infection, body mass index, lung function, medication, and diabetes, as well as data of Pseudomonas infection status, antibiotic treatment and hospitalization from 1-year follow-up.
We found no differences in lung function, body mass index, or frequency of diabetes. The adult group consisted of more males than females (208:168). We found no significant difference in prevalence of chronic Pseudomonas aeruginosa infection, but during the follow-up the incidence of new chronic infection was higher in adult females (10/33 vs. 4/56). Females had higher prevalence of Burkholderia infection (21/416 vs. 11/474). Adult females had more days on intravenous antibiotics (median 39 vs. 26 days/year), and days in hospital (median 2 vs. 0 days/year). More adult females received inhaled and oral steroids. In the pediatric cohort, females were treated more often with macrolides as an anti-inflammatory agent.
We found no gender difference in key clinical parameters in our CF population. However, our study showed a higher risk of Pseudomonas and Burkholderia infection among the female patients. Additionally, we found that female patients require more intensified treatment regarding antibiotics, macrolides, steroids and days of hospitalization, indicating a true female disadvantage even with modern aggressive treatment. The finding of more males than females in the adult population suggesting a male advantage, warrants a mortality study.
探讨斯堪的纳维亚囊性纤维化 (CF) 患者在关键临床参数、并发症和药物治疗方面是否存在性别差异。
对 890 名(416 名女性)胰腺功能不全 CF 患者的横断面数据进行评估,评估内容包括慢性感染、体重指数、肺功能、药物治疗和糖尿病,以及 1 年随访期间铜绿假单胞菌感染状态、抗生素治疗和住院的数据。
我们发现肺功能、体重指数或糖尿病的频率没有差异。成年组男性多于女性(208:168)。我们发现慢性铜绿假单胞菌感染的患病率没有显著差异,但在随访期间,成年女性新发慢性感染的发生率更高(10/33 比 4/56)。女性感染鲍曼不动杆菌的比例更高(21/416 比 11/474)。成年女性静脉用抗生素的天数更多(中位数 39 比 26 天/年),住院天数也更多(中位数 2 比 0 天/年)。更多的成年女性接受了吸入和口服类固醇治疗。在儿科队列中,女性更常使用大环内酯类药物作为抗炎药物。
我们在 CF 人群中未发现关键临床参数存在性别差异。然而,我们的研究表明,女性患者感染铜绿假单胞菌和鲍曼不动杆菌的风险更高。此外,我们发现女性患者需要更强化的抗生素、大环内酯类药物、类固醇和住院天数治疗,这表明即使采用现代积极的治疗方法,女性也处于真正的劣势。成年人群中男性多于女性的发现表明男性具有优势,需要进行死亡率研究。