非艾滋病非器官移植免疫抑制宿主巨细胞病毒肺炎临床特征分析  

Clinical features of cytomegalovirus pneumonia in non-AIDS,non-transplanted immunocompromised patients

作　　者：占扬清 曾沛荧 程璘令[1] 潘枫渝 陈荣昌[1] 叶枫[1] ZHAN Yang-qing;ZENG Pei-ying;CHENG Lin-ling;PAN Feng-yu;CHEN Rong-chang;YE Feng(Department of Pulmonary and Critical Care Medicine,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou Institute of Respiratory Health,State Key Laboratory of Respiratory Disease,National Clinical Research Centre for Respiratory Disease,Guangzhou 510120,China)

机构地区：[1]广州医科大学附属第一医院,呼吸与危重症医学科,广州呼吸健康研究院,呼吸疾病国家重点实验室,呼吸疾病国家临床医学研究中心,广东广州510120

出　　处：《中国实用内科杂志》2020年第6期471-475,共5页Chinese Journal of Practical Internal Medicine

基　　金：国家科技重大专项课题(编号:2017ZX09304005002)。

摘　　要：目的探讨和分析非艾滋病、非器官移植的免疫抑制宿主发生巨细胞病毒(CMV)肺炎的临床特征及预后不良的危险因素。方法回顾性分析2017年7月至2018年12月确诊的CMV肺炎患者临床资料,根据出院时的转归分为好转组、恶化/死亡组,对恶化/死亡的危险因素行Logistic回归分析。结果共28例患者满足入选标准,好转组23例,恶化/死亡组5例(1例死亡,4例恶化后自动出院)。首发症状均以咳嗽、发热、呼吸困难为最常见,胸部影像学以弥漫磨玻璃影、斑片实变影为最常见的表现。单因素Logistic回归分析显示LDH升高、机械通气、入院后糖皮质激素使用是CMV肺炎预后不良的危险因素。结论 LDH升高、需要机械通气、入院后糖皮质激素使用是CMV肺炎预后不良的危险因素。Objective To analyze clinical features and risk factors of poor outcome in non-AIDS,non-transplanted immunocompromised patients with cytomegalovirus pneumonia.Methods Clinical data of patients diagnosed with confirmed cytomegalovirus pneumonia between July 2017 and December 2018 were retrospectively analyzed.The patients were categorized as improved group and deteriorated/death group according to outcomes after hospitalization.Logistic regression was conducted to evaluate the risk factors for poor outcome.Results Overall,28 cases were enrolled in the study.There were 23 cases in improved group and 5 in deteriorated/death group(one death and 4 discharged after deterioration).The most common primary symptoms included cough,fever and dyspnea.Diffused ground glass opacity,patchy or consolidation were the most common imaging features in chest CT.Univariate Logistic regression showed that elevated serum lactate dehydrogenase(LDH),mechanical ventilation and corticosteroid treatment during hospitalization were risk factors for poor outcome.Conclusion Elevated serum LDH,mechanical ventilation and corticosteroid treatment during hospitalization are risk factors for poor outcome in cytomegalovirus pneumonia patients.

关 键 词：巨细胞病毒肺炎 免疫抑制 临床特征 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]