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原发性纤毛运动障碍的诊断:欧洲呼吸学会工作组报告总结

Diagnosis of primary ciliary dyskinesia: summary of the ERS Task Force report.

作者信息

Kuehni Claudia E, Lucas Jane S

机构信息

Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.

Paediatric Respiratory Medicine, Inselspital, University Children's Hospital of Bern, University of Bern, Bern, Switzerland.

出版信息

Breathe (Sheff). 2017 Sep;13(3):166-178. doi: 10.1183/20734735.008517.

Abstract

KEY POINTS

Primary ciliary dyskinesia (PCD) is a genetically and clinically heterogeneous disease characterised by abnormal motile ciliary function.There is no "gold standard" diagnostic test for PCD.The European Respiratory Society (ERS) Task Force Guidelines for diagnosing PCD recommend that patients should be referred for diagnostic testing if they have several of the following features: persistent wet cough; situs anomalies; congenital cardiac defects; persistent rhinitis; chronic middle ear disease with or without hearing loss; or a history, in term infants, of neonatal upper and lower respiratory symptoms or neonatal intensive care admission.The ERS Task Force recommends that patients should be investigated in a specialist PCD centre with access to a range of complementary tests: nasal nitric oxide, high-speed video microscopy analysis and transmission electron microscopy. Additional tests including immunofluorescence labelling of ciliary proteins and genetic testing may also help determine the diagnosis.

EDUCATIONAL AIMS

This article is intended for primary and secondary care physicians interested in primary ciliary dyskinesia (PCD), those who identify patients for testing, and those involved in diagnosing and managing PCD patients. It aims: to inform readers about the new European Respiratory Society Task Force Guidelines for diagnosing patients with PCDto enable primary and secondary care physicians to: identify patients who need diagnostic testing; understand the diagnostic tests that their patients will undergo, the results of the tests and their limitations; and ensure that appropriate care is subsequently delivered.

摘要

要点

原发性纤毛运动障碍(PCD)是一种遗传和临床异质性疾病,其特征为纤毛运动功能异常。目前尚无PCD的“金标准”诊断测试。欧洲呼吸学会(ERS)诊断PCD的工作组指南建议,如果患者具有以下几种特征,应转诊进行诊断测试:持续性湿性咳嗽;内脏反位;先天性心脏缺陷;持续性鼻炎;伴有或不伴有听力损失的慢性中耳疾病;或足月儿有新生儿上、下呼吸道症状或新生儿重症监护病房住院史。ERS工作组建议,患者应在能够进行一系列补充检查的专业PCD中心接受检查:鼻一氧化氮检测、高速视频显微镜分析和透射电子显微镜检查。其他检查,包括纤毛蛋白的免疫荧光标记和基因检测,也可能有助于明确诊断。

教育目标

本文面向对原发性纤毛运动障碍(PCD)感兴趣的基层和二级医疗机构医生、负责识别患者进行检测的人员以及参与PCD患者诊断和管理的人员。其目的是:向读者介绍欧洲呼吸学会工作组关于诊断PCD患者的新指南,使基层和二级医疗机构医生能够:识别需要诊断检测的患者;了解其患者将接受的诊断检测、检测结果及其局限性;并确保随后提供适当的护理。

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