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在急性至慢性肝衰竭患者中侵袭性肺阿斯伯吉洛症的预测因素:一项回顾性研究

Chenxi Yuan^1,2, Rongqing Zhu^1,2, Lifen Hu^1,2

¹Department of Infectious Diseases & Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China.

Infection and drug resistance

|February 24, 2025

概括

这项研究确定了急性至慢性肝衰竭 (ACLF) 患者侵入性肺阿斯伯吉洛症 (IPA) 的早期预警因素. 早期发现恶心和咳等症状可以帮助及时干预这种严重的共感染.

科学领域:

肝病学肝病学是一种肝病学.
传染性疾病传染性疾病
关键护理医学关键护理医学

背景情况:

急性至慢性肝衰竭 (ACLF) 是一种具有高死亡率的危急疾病.
与侵袭性肺阿斯伯吉洛症 (IPA) 的同时感染显著增加了ACLF患者的发病率和死亡率.

研究的目的:

在急性至慢性肝衰竭 (ACLF) 患者中确定侵入性肺阿斯伯吉洛症 (IPA) 的早期预警因素.
在ACLF患者中探索IPA共感染的预后影响.

主要方法:

从438名ACLF患者的临床,生化和微生物数据的回顾性分析 (2019年5月-2023年5月).
单变量和多变量分析以确定IPA的独立风险因素.
曲线下的面积 (AUC) 和决策曲线分析 (DCA) 来评估模型性能.

主要成果:

在6.8%的ACLF患者中诊断出IPA;在IPA共感染患者中,28天死亡率更高 (56.7%vs29.4%).
IPA的独立早期预警因素包括恶心,吐,细菌/真菌感染,皮质类固醇使用,手术,血和白细胞计数升高.
一个预测模型显示出高有效性,AUC为0.934.

结论:

恶心,咳,现有的感染,皮质类固醇使用,之前的手术,血和高白细胞计数是ACLF患者IPA的关键指标.
开发的模型为ACLF早期IPA诊断提供了有效的临床实用性.
基于这些早期预警因素的及时干预可能会改善IPA的ACLF患者的结果.

关键词:

急性-慢性肝功能衰竭肝功能衰竭决策曲线分析的方法侵袭性肺部阿斯伯吉洛症

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