进展性肺纤维化进展的结果和预测因素
Zekai Cen1, Tiantian Cen1, Qunli Ding1
1Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
高龄,高瘤标志物和肺功能不良预测了渐进性肺纤维化 (PPF) 的发展. 肺动脉压力的增加和急性恶化是PPF患者死亡的关键风险因素.
科学领域:
- 肺部病理学 肺部病理学
- 间歇性肺病 间歇性肺病
- 纤维化间歇性肺病 纤维化间歇性肺病
背景情况:
- 渐进性肺纤维化 (PPF) 是一种严重的间歇性肺病 (ILD) 亚组,其特征是渐进性纤维化 (PF) 现型.
- 患有PPF的患者肺功能,运动能力和整体生活质量显著下降.
- 了解PPF的临床特征和进展因素对于改善患者的治疗结果至关重要.
研究的目的:
- 调查患有渐进性纤维化 (PF) 现型的间歇性肺病 (ILD) 患者的临床特征.
- 确定与从纤维性ILD (f-ILD) 到PPF的疾病进展相关的潜在因素.
- 分析被诊断患有PPF的患者的生存结果.
主要方法:
- 在宁波大学第一附属医院从2011年1月到2022年12月的ILD患者数据的回顾性审查.
- 根据已建立的PPF临床实践指南,识别具有PF表型的患者.
- 基线临床信息,实验室参数和成像发现 (胸部HRCT) 的分析.
主要成果:
- 与非PPF患者相比,在基线时,PPF患者表现出较高的瘤标志物水平和降低的肺功能 (较低的FVC,DLCO).
- 多变量逻辑回归确定年龄>65,升高的LDH,高的CA-153,减少的FVC/DLCO和UIP类的HRCT模式作为PPF进展的预测因素.
- PPF组的生存率明显较低;高SPAP (≥37 mmHg) 和急性恶化是死亡率的独立预后因素.
结论:
- 年龄较大,瘤标志物升高 (CA-153,LDH),肺功能受损以及特定的HRCT模式与f-ILD向PPF的进展有关.
- 系统性肺动脉压升高 (SPAP) 和急性恶化 (AE) 是PPF患者死亡的重要独立风险因素.
- 密切监测和针对这些风险因素的患者的有针对性的干预措施对于改善PPF的预后至关重要.
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