巴西慢性肺阿斯伯吉洛症的临床特征和死亡率:一个多中心队列研究
Vítor Falcão de Oliveira1,2,3, João Antonio Gonçalves Garreta Prats4, Valdes Roberto Bollela5
1Division of Infectious Diseases, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.
Open forum infectious diseases
|January 15, 2026
概括
巴西的慢性肺阿斯伯吉洛症 (CPA) 死亡率较低,特别是在结核病 (TB) 患者中. 结核病流行地区的重叠症状可能会推迟诊断和治疗.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 有限的数据存在于资源有限,高结核病 (TB) 设置,如巴西的慢性肺阿斯伯吉洛症 (CPA).
- 了解CPA在这些地区的临床形状和预后至关重要.
研究的目的:
- 评估巴西CPA的临床特征,诊断,治疗和死亡率.
- 确定与CPA患者死亡率相关的因素,特别是同时存在的结核病的影响.
主要方法:
- 一项多中心追溯研究,涉及巴西2012年至2018年间诊断的191例CPA病例.
- 分析包括临床表现,抗真菌疗法,手术和死亡率.
- 多变量考克斯回归和卡普兰-梅尔生存分析被用来确定死亡率预测因素.
主要成果:
- CPA患者的平均年龄为50岁,其中62%为男性. 结核病 (TB) 是最常见的潜在疾病 (72%).
- 一年累积死亡率为6%. 结核病患者的死亡率明显较低 (52%与非结核病患者的77%相比,P=.019).
- 结核病与较低的死亡率独立相关 (HR 0.413,P=.038). 结核病患者表现出更多的血和放射性参与,这表明诊断延迟.
结论:
- 巴西的CPA死亡率低于此前报告的水平,特别是在结核病患者中.
- 结核病流行地区的临床和放射学特征重叠可能会延迟诊断和治疗的开始.
- 需要进一步的研究,以优化CPA管理在资源有限的设置.
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