TY-Jour T1 - 肺炎素霉素的随机对照试验，以防止肺移植后慢性排斥反应JF - 欧洲呼吸杂志Jo - Eur Respir J SP - 164 LP - 172 Do - 10.1183 / 09031936.00068310 VL - 37是 - 1 Au - Vos，R. AU - Vanaudenaerde, B.M. AU - Verleden, S.E. AU - De Vleeschauwer, S.I. AU - Willems-Widyastuti, A. AU - Van Raemdonck, D.E. AU - Schoonis, A. AU - Nawrot, T.S. AU - Dupont, L.J. AU - Verleden, G.M. Y1 - 2011/01/01 UR - //www.qdcxjkg.com/content/37/1/164.abstract N2 - Azithromycin reduces airway inflammation and improves forced expiratory volume in 1 s (FEV1) in chronic rejection or bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTx). Azithromycin prophylaxis might prevent BOS. A double-blind randomised controlled trial of azithromycin (n = 40) or placebo (n = 43), initiated at discharge and administered three times a week for 2 yrs, was performed in 2005–2009 at the Leuven University Hospital (Leuven, Belgium). Primary end-points were BOS-free and overall survival 2 yrs after LTx; secondary end-points were acute rejection, lymphocytic bronchiolitis and pneumonitis rate, prevalence of pseudomonal airway colonisation or gastro-oesophageal reflux, and change in FEV1, airway and systemic inflammation over time. Patients developing BOS were assessed for change in FEV1 with open-label azithromycin. BOS occurred less in patients receiving azithromycin: 12.5 versus 44.2% (p = 0.0017). BOS-free survival was better with azithromycin (hazard ratio 0.27, 95% CI 0.092–0.816; p = 0.020). Overall survival, acute rejection, lymphocytic bronchiolitis, pneumonitis, colonisation and reflux were comparable between groups. Patients receiving azithromycin demonstrated better FEV1 (p = 0.028), and lower airway neutrophilia (p = 0.015) and systemic C-reactive protein levels (p = 0.050) over time. Open-label azithromycin for BOS improved FEV1 in 52.2% patients. No serious adverse events were noted. Azithromycin prophylaxis attenuates local and systemic inflammation, improves FEV1 and reduces BOS 2 yrs after LTx. ER -