论文部分内容阅读
目的:分析间质性肺炎合并侵袭性肺曲霉病(invasive pulmonary aspergillosis,IPA)的临床特点和死亡危险因素。方法:回顾性分析2010年12月至2016年4月本院49例间质性肺炎合并IPA患者的临床资料,以诊断后12周为观察终点,将患者分为存活组和死亡组,对两组病例的临床资料进行对比,分析间质性肺炎合并IPA的死亡危险因素。结果:单因素分析显示,年龄>65岁、低蛋白血症、氧合指数<300、胸部CT示弥漫性磨玻璃影和诊断时间>7 d是间质性肺炎合并IPA的死亡危险因素(P<0.05),伏立康唑治疗的患者预后较好(P=0.033)。Logistic多因素回归分析仅发现氧合指数<300是影响间质性肺炎合并IPA患者预后的死亡危险因素(P=0.016,OR=4.833,95%CI:1.669~138.659,β=2.722,SE=1.128,Wald=5.827)。结论:入院时已发生呼吸衰竭是间质性肺炎合并IPA患者死亡的独立危险因素。
Objective: To analyze the clinical features and risk factors of death in interstitial pneumonia complicated with invasive pulmonary aspergillosis (IPA). Methods: The clinical data of 49 patients with IPA complicated with IPA from December 2010 to April 2016 were retrospectively analyzed. The patients were divided into survival group and death group at 12 weeks after diagnosis. Group of patients with clinical data were compared to analyze the risk of interstitial pneumonia with IPA risk of death. Results: Univariate analysis showed that age> 65 years, hypoalbuminemia, oxygenation index <300, chest CT showed diffuse ground glass and diagnostic time> 7 d were the risk factors for the death of interstitial pneumonia with IPA (P <0.05), and voriconazole-treated patients had a better prognosis (P = 0.033). Logistic multivariate regression analysis found that the oxygenation index <300 was the risk factor for mortality in patients with interstitial pneumonia complicated with IPA (P = 0.016, OR = 4.833, 95% CI: 1.669-138.659, β = 2.722, SE = 1.128 , Wald = 5.827). Conclusion: Respiratory failure occurred on admission is an independent risk factor for the death of patients with interstitial pneumonia complicated with IPA.