肝硬化是Pneumocystis jirovecii相关死亡率的一个危险因素
Georg Peschel1,2, Nils Happ1, Jan Bornschein1,3
1Department of Internal Medicine I, University Hospital of Regensburg, Regensburg, Germany.
Frontiers in medicine
|October 24, 2024
概括
肺囊吉罗维奇肺炎 (PCP) 显著增加肝硬化患者的死亡率,特别是那些患有晚期疾病的患者. 肝硬化相关的免疫功能障碍增加了对真菌感染的易感性,需要针对性治疗.
科学领域:
- 传染性疾病 传染性疾病
- 肝病学 肝病学是一种肝病学.
- 关键护理医学 关键护理医学
背景情况:
- 肺囊炎 (Pneumocystis jirovecci) 肺炎 (PCP) 是免疫功能低下个体的一种严重感染.
- 肝硬化可以导致免疫缺陷,但其对PCP结果的影响尚不清楚.
研究的目的:
- 确定PCP患者,特别是肝硬化患者的死亡率预测因素.
- 调查肝硬化与PCP相关死亡率之间的关联.
主要方法:
- 在2013年至2019年期间入住ICU的151名PCR确诊的PCP患者的回顾性分析.
- 对PCP相关死亡率的临床预测因素的评估,包括肝硬化状态和严重程度 (Child-Pugh等级,MELD得分).
主要成果:
- 总的死亡率为60%.
- 44%的患者患有肝硬化,Child-Pugh C级显示84.7%的死亡率.
- 肝硬化显著增加死亡风险 (OR:4.809),MELD得分与死亡率相关 (r=0.612).
结论:
- 晚期肝硬化是PCP患者死亡率的关键预测因素.
- 肝硬化相关的免疫功能障碍可能会增加对像PCP这样的真菌感染的敏感性.
- 对CAID表型的进一步研究可以为免疫向疗法提供信息,以减少肝硬化患者的死亡率.
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