Zhou Wangji, Wang Yaqi, Yang Yanli, Sun Yanyan, Cheng Chongsheng, Dai Jinrong, Meng Shuzhen, Chen Keqi, Zhao Yang, Liu Xueqi, Zhang Dingding, Liu Song, Zhu Weiguo, Liu Yaping, Xu Kai-Feng, Tian Xinlun
Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, State Key Laboratory of Common Mechanism Research for Maior Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Center of Medical Research, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Orphanet J Rare Dis. 2025 Jan 7;20(1):6. doi: 10.1186/s13023-024-03522-1.
Patients with cystic fibrosis (CF) are rare in China and differ significantly from the Caucasian populations in terms of clinical and genetic characteristics. However, the progression and mortality of Chinese patients with CF have not been well described.
This study included all 67 patients from the Peking Union Medical College Hospital CF cohort, with a median followed up time of 5.2 years. Compared to patients diagnosed with CF in childhood, adult-diagnosed patients exhibit a lower proportion of pancreatic exocrine insufficiency (25.0% vs. 77.8%, P = 0.001) and a higher body mass index (19.6 vs. 17.7 kg/m, P = 0.045). According to the mixed-effects model, for patients ≤ 30 years of age at diagnosis, FEV% predicted decreased 1.17% per year. The generalized linear regression model showed that higher baseline FEV% predicted and occurrence of pulmonary exacerbations were associated with the progression of patients with CF. The survival rates at 5 years and 10 years after the diagnosis were 96.7% and 80.6%, respectively. The log-rank test showed baseline FEV% predicted < 50%, and high CF-ABLE and 3-year prognostic scores were associated with mortality in patients with CF in China.
We reported the progression and mortality of patients with CF in China, which was a rare and relatively unknown population in the past. Baseline FEV% predicted is associated with progression and mortality. Pulmonary exacerbations can accelerate the decline in lung function. The CF-ABLE and 3-year prognostic scores are applicable for predicting poor prognosis in patients with CF in China.
囊性纤维化(CF)患者在中国较为罕见,其临床和基因特征与白种人群有显著差异。然而,中国CF患者的疾病进展和死亡率尚未得到充分描述。
本研究纳入了北京协和医院CF队列中的所有67例患者,中位随访时间为5.2年。与儿童期诊断为CF的患者相比,成年期诊断的患者胰腺外分泌功能不全的比例较低(25.0%对77.8%,P = 0.001),体重指数较高(19.6对17.7kg/m²,P = 0.045)。根据混合效应模型,对于诊断时年龄≤30岁的患者,预计FEV%每年下降1.17%。广义线性回归模型显示,较高的基线预计FEV%和肺部加重的发生与CF患者的疾病进展相关。诊断后5年和10年的生存率分别为96.7%和80.6%。对数秩检验显示,基线预计FEV%<50%、高CF-ABLE和3年预后评分与中国CF患者的死亡率相关。
我们报告了中国CF患者的疾病进展和死亡率,这是一个过去罕见且相对不为人知的群体。基线预计FEV%与疾病进展和死亡率相关。肺部加重可加速肺功能下降。CF-ABLE和3年预后评分适用于预测中国CF患者的不良预后。