结缔组织病相关性间质性肺病合并肺感染的临床表现特点及感染相关因素分析  

Analysis of clinical characteristics and infection-related factors of connective tissue disease-associated interstitial lung disease combined with pulmonary infection

作　　者：林志来 陈玉华 潘建光 江梅琴 Lin Zhilai;Chen Yuhua;Pan Jianguang;Jiang Meiqin(Department of Respiratory Medicine,Fuzhou Pulmonary Hospital of Fujian,Fuzhou,Fujian 350008,China)

机构地区：[1]福建省福州肺科医院呼吸内科,福建福州350008

出　　处：《感染．炎症．修复》2022年第4期200-204,共5页Infection Inflammation Repair

基　　金：福建省卫生和计划生育委员会省级临床重点专科建设项目资助[闽卫医政函(2018)145号]。

摘　　要：目的:探讨结缔组织病相关性间质性肺病(CTD-ILD)合并肺感染患者的临床表现特征,并分析其感染相关因素。方法:回顾性分析福州肺科医院呼吸内科2018年8月—2020年10月收治的152例CTD-ILD住院患者的临床资料,比较91例合并肺感染(感染组)患者和61例未合并肺感染(非感染组)患者的一般情况、临床表现、相关实验室检查等指标的差异,利用Logistic多元回归方法分析肺感染的独立影响因素。结果:CTD-ILD合并肺感染患者呼吸道相关临床表现与非感染组之间差异有显著的统计学意义(P <0.05),感染组患者多有发热、咳嗽、咳痰、胸闷、气喘、肺部干性或湿性啰音等表现;感染组血白细胞、C反应蛋白、红细胞沉降率、中性粒细胞百分比升高(P <0.05),血清白蛋白水平和动脉血氧分压明显低于非感染组(P <0.05);感染组高分辨率CT支气管扩张表现重于非感染组(P <0.05)。多因素分析结果显示,C反应蛋白≥28.45 mg/L、血清白蛋白降低、支气管扩张的高分辨率CT表现是CTD-ILD合并肺感染的独立危险因素(P <0.05)。结论:CTD-ILD合并肺感染以发热、咳嗽、咳痰、胸闷、气喘等临床表现为特点,C反应蛋白≥28.45 mg/L、血清白蛋白降低及支气管扩张是CTD-ILD患者合并肺感染的独立危险因素。Objective:To explore the clinical characteristics and the infection-related factors of CTD-ILD combined with pulmonary infection.Methods:The clinical data of 152 CTD-ILD patients admitted to the Department of Respiratory Medicine,Fuzhou Pulmonary Hospital from Aug.2018 to Oct.2020 was retrospectively analyzed.The differences of general conditions,clinical manifestations,relevant laboratory examination and other indexes between 91 patients with pulmonary infection(infection group)and 61 patients without pulmonary infection(non-infection group)were compared.Logistic multiple regression method was used to analyzed the indepndent influence factors affecting pulmonary infection.Results:There was statistically significant difference in the respiratory related clinical manifestations of CTD-ILD patients with pulmonary infection compared with the non-infection group(P<0.05).In the infection group,there were fever,cough and sputum,chest distress and asthma,dry or wet rales in the lungs.Blood leukocyte,C-reactive protein,erythrocyte sedimentation rate and neutrophil percentage in the infection group were increased(P<0.05).Serum albumin level and arterial partial pressure of oxygen were significantly lower than those in the non-infection group(P<0.05),the results of high resolution CT(HRCT)of bronchiectasis in the infection group were higher than those in the non-infection group(P<0.05).Correlation analysis results showed that C-reactive protein≥28.45 mg/L,decreased serum albumin,and HRCT of bronchiectasis were independent risk factors for CTDILD combined with pulmonary infection(P<0.05).Conclusions:The CTD-ILD patients combined with pulmonary infection are characterized by fever,cough and expectoration,chest tightness and asthma.C-reactive protein≥28.45 mg/L,decreased serum albumin,and HRCT of bronchiectasis are independent risk factors for CTD-ILD combined with pulmonary infection.

关 键 词：结缔组织病 间质性肺病 肺感染 危险因素 支气管扩张 

分 类 号：R56[医药卫生—呼吸系统]