感染性并发症与支气管异位移动性衰变相关的肺移植接受者的肺移植患者
Andrew M Courtwright1, Jeffery B Doyon2, Emily A Blumberg2
1Division of Pulmonology, Allergy, and Critical Care, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Clinical transplantation
|May 30, 2023
概括
肺移植受体的支气管静脉脱光症 (AD) 通常涉及细菌感染,特别是阴性杆菌. 重要的是,在AD愈合之前的感染并不能预测支气管狭窄症的发展.
科学领域:
- 肺部医学 肺部医学
- 移植手术 移植手术
- 传染性疾病 传染性疾病
背景情况:
- 支气管静脉脱光 (AD) 是肺移植后的一种严重并发症.
- 阿尔茨海默病与患者的显著发病率和死亡率有关.
- 了解阿尔茨海默病的感染对于患者的治疗结果至关重要.
研究的目的:
- 在肺移植后的支气管静脉性消化 (AD) 中表征真菌和细菌感染.
- 为了确定与AD相关的感染是否与支气管狭窄症的进展相关.
主要方法:
- 2015-2021年615名肺移植接受者的单中心研究.
- 根据ISHLT共识指南定义的呼吸道并发症.
- 分析感染类型和与狭窄发展的关联.
主要成果:
- 3.6%的接受者 (22/615) 患有阿尔茨海默病,往往先有支气管缺血/亡.
- 在AD (63.6%) 之前,细菌感染 (克负棒) 是常见的.
- 观测到多叶膜感染 (Candida) 和死后的阿斯伯吉洛菌;二次感染与狭窄无关 (OR=0.41).
结论:
- 发生前后的支气管解剖学脱 (AD) 中,格兰阴性细菌感染很普遍.
- 胸腔感染是常见的,应该怀疑.
- 在AD愈合之前发生的感染与随后发展的气道狭窄症无关.
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