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分析不同免疫状态人群社区获得性肺炎所致急性呼吸窘迫综合征的临床特征及预后因素。

Analysis of clinical characteristics and prognostic factors of ARDS caused by community-acquired pneumonia in people with different immune status.

机构信息

Department of Respiratory and Critical Care Medicine, First Medical Center, PLA General Hospital, Beijing, China.

出版信息

Expert Rev Anti Infect Ther. 2022 Dec;20(12):1643-1650. doi: 10.1080/14787210.2022.2142116. Epub 2022 Nov 3.

Abstract

BACKGROUND

The purpose of this study is to describe the clinical characteristics and prognostic risk factors of acute respiratory distress syndrome (ARDS) caused by community-acquired pneumonia under different immune states.

METHODS

The patients were divided into immunocompetent and immunocompromised groups according to their immune status. The basic clinical data of the two groups were collected and statistically analyzed, and the clinical characteristics and prognostic factors of ARDS caused by community-acquired pneumonia under different immune states were summarized.

RESULTS

128 patients with ARDS caused by community-acquired pneumonia were enrolled. The chest High-Resolution Computed Tomography (HRCT) scores of patients with immunosuppression were higher (236.0 ± 55.0 vs. 207.5 ± 49.6, p < 0.05) and the score of APACHE II was higher (17.3 ± 4.8 vs. 15.1 ± 5.4, p < 0.05). The 28-day intensive care unit (ICU) mortality was higher in the immunocompromised group (54.5% vs. 34.7%, p = 0.045). The 28-day in-hospital mortality in the immunocompetent group was mainly related to NLR and the oxygenation index. The 28-day in-hospital mortality in the immunocompromised group was mainly related to LDH and APACHE II.

CONCLUSION

There are differences in clinical characteristics and mortality of ARDS patients caused by community-acquired pneumonia under different immune states.

摘要

背景

本研究旨在描述不同免疫状态下社区获得性肺炎所致急性呼吸窘迫综合征(ARDS)的临床特征和预后危险因素。

方法

根据免疫状态将患者分为免疫正常组和免疫低下组,收集两组的基本临床资料并进行统计学分析,总结不同免疫状态下社区获得性肺炎所致 ARDS 的临床特征和预后危险因素。

结果

共纳入 128 例社区获得性肺炎所致 ARDS 患者,免疫低下组患者的胸部高分辨率 CT(HRCT)评分更高(236.0±55.0 比 207.5±49.6,p<0.05),APACHE II 评分更高(17.3±4.8 比 15.1±5.4,p<0.05)。免疫低下组 28 天 ICU 病死率更高(54.5%比 34.7%,p=0.045)。免疫正常组 28 天院内病死率主要与 NLR 和氧合指数相关,免疫低下组 28 天院内病死率主要与 LDH 和 APACHE II 相关。

结论

不同免疫状态下社区获得性肺炎所致 ARDS 患者的临床特征和病死率存在差异。

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