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肺孢子菌肺炎:HIV 与非 HIV 免疫功能低下患者的比较研究。

Pneumocystosis pneumonia: A comparison study between HIV and non-HIV immunocompromised patients.

机构信息

Serviço de Medicina 7.2, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central (CHULC), Lisboa, Portugal.

Serviço de Medicina 7.2, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central (CHULC), Lisboa, Portugal.

出版信息

Pulmonology. 2019 Sep-Oct;25(5):271-274. doi: 10.1016/j.pulmoe.2019.04.003. Epub 2019 May 7.

Abstract

Pneumocystis pneumonia (PCP) is caused by the fungus Pneumocystis jirovecii, and its incidence has been on the rise in immunosuppressed patients without HIV. We performed a cross sectional study in patients with PCP and assessed demographic, clinical presentation and outcome measures such as mechanical ventilation and mortality differences between HIV and non-HIV patients. The two groups were statistically significantly different, with the HIV group being younger (45.5 years vs 55.9 years, p-value 0.001) and mostly composed of male patients (69% vs 31%, p-value <0.001). Also, the HIV patients had higher percentage of respiratory complaints (90% vs 68%, p-value 0.02) and lactate dehydrogenase elevation (73% vs 40%, p-value 0.001). In contrast, non-HIV patients had worse outcomes with higher incidence of invasive mechanical ventilation (23% vs 46%, p-value 0.005) and in-hospital mortality (13% vs 37%, p-value 0.002). These results reflect the literature and should raise awareness to a potentially fatal medical situation of increasing incidence.

摘要

卡氏肺孢子菌肺炎(PCP)由真菌卡氏肺孢子菌引起,在无 HIV 的免疫抑制患者中其发病率一直在上升。我们对 PCP 患者进行了一项横断面研究,并评估了人口统计学、临床表现以及机械通气和死亡率等预后指标在 HIV 患者和非 HIV 患者之间的差异。两组在统计学上存在显著差异,HIV 组患者更年轻(45.5 岁比 55.9 岁,p 值 0.001),且大多数为男性(69%比 31%,p 值<0.001)。此外,HIV 患者出现呼吸症状的比例更高(90%比 68%,p 值 0.02),乳酸脱氢酶升高的比例也更高(73%比 40%,p 值 0.001)。相比之下,非 HIV 患者的预后更差,需要有创机械通气的比例更高(23%比 46%,p 值 0.005),住院死亡率也更高(13%比 37%,p 值 0.002)。这些结果反映了文献中的情况,应引起人们对发病率不断上升的这种潜在致命医疗情况的重视。

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