在患有由肺囊炎肺炎复杂的自身免疫疾病的患者中,死亡率的预后因素
Kunika Shimizu1, Nobuyuki Yajima1, Ryo Yanai1
1Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, JPN.
Cureus
|September 25, 2024
概括
在自身免疫性疾病患者中,肺囊性肺炎 (PCP) 的死亡率很高. 男性性别,低IgA/白蛋白,低PaO2/FiO2和高肌素/CRP表明PCP患者的预后不佳.
科学领域:
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
- 关键护理医学 关键护理医学
背景情况:
- 肺囊性肺炎 (PCP) 在患有自身免疫性疾病的患者中具有显著的死亡风险,超过了人类免疫缺陷病毒 (HIV) -PCP.
- 识别死亡风险因素对于改善这一弱势群体的结果至关重要.
研究的目的:
- 调查诊断为患有由肺囊性肺炎 (PCP) 复杂的自身免疫性疾病的患者死亡率相关的风险因素.
主要方法:
- 对38名患有自身免疫性疾病和PCP的患者进行了回顾性观察性研究.
- 诊断涉及临床症状,成像,实验室测试 (低血,高 (1,3) -β-D-葡萄糖) 和肺囊 jirovecii PCR.
- 统计分析比较了使用费舍尔精确和曼-惠特尼U测试的幸存者和非幸存者.
主要成果:
- 研究小组的平均年龄为72.4岁,类风湿性关节炎是最常见的潜在疾病.
- 死亡率为18% (7/38).死亡率为18% (7/38).死亡率为7%,死亡率为7%,死亡率为9%.
- 与死亡率增加相关的因素包括男性性别,较高的血清肌素和C反应蛋白 (CRP) 水平,较低的白蛋白和免疫球蛋白A (IgA) 水平,以及较低的PaO2/FiO2比率.
结论:
- 男性性别,低IgA和白蛋白水平,低PaO2 / FiO2比率,以及较高的肌素和CRP水平是PCP自身免疫性疾病患者预后不佳的显著预测因素.
- 这些发现可以帮助识别高风险个体,并为有关预防性三甲-硫甲醇 (TMP-SMX) 管理的决定提供信息.
- 需要进一步的研究来探索预防性TMP-SMX和新生物药物和免疫抑制剂对PCP死亡率的影响.
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