基础疾病对隐球菌病患者临床症状和转归的影响

发布时间：2018-05-20 02:03

本文选题：隐球菌病 + 临床特征　；参考：《医学研究生学报》2015年07期

【摘要】：目的隐球菌病是一种具有潜在致死性的深部真菌病,易感人群均有显著异质性。目前指南将感染人群分为获得性免疫缺陷综合征、器官移植受者和非HIV感染与非器官移植患者(non-HIV-infected and non-transplant host,NHNT)。文中旨在探讨基础疾病对NHNT隐球菌病患者临床症状和转归的影响。方法采用回顾性的队列研究设计,收集南京军区南京总医院NHNT隐球菌病住院患者临床资料。根据发病时是否处于免疫缺陷状态或合并有增加感染风险的疾病将患者分为有基础疾病组和无基础疾病组,分析2组患者临床症状、胸部影像学特征、实验室检查和临床结局等相关数据。结果与无基础疾病患者相比,有基础疾病患者更容易出现播散性病变(62.9%vs 21.1%,P0.001),胸部影像学中出现斑片实变影者和混合病变的患者比例更高,分别为(47.4%vs 16.7%)与(31.6%vs 3.3%),P0.05。此外,该类患者总体病死率更高(30.0%vs 5.3%,P=0.016)。结论基础疾病对NHNT隐球菌病患者的临床症状和转归存在显著影响。有基础疾病的NHNT患者容易发生播散性病变,具有更为严重的临床症状与更高的总体病死率。
[Abstract]:Objective Cryptococcosis is a potentially fatal deep mycosis with significant heterogeneity in susceptible populations. The current guidelines divide infected populations into acquired immunodeficiency syndrome, organ transplant recipients, non-HIV-infected and non-transplant hosts and non-organ transplant patients. The purpose of this paper is to investigate the effect of basic diseases on clinical symptoms and prognosis of patients with cryptococcal disease (NHNT). Methods A retrospective cohort design was used to collect the clinical data of NHNT Cryptococcosis inpatients in Nanjing General Hospital of Nanjing military region. Patients were divided into two groups according to whether they were in a state of immune deficiency at the time of onset or were at increased risk of infection. The clinical symptoms and chest imaging characteristics of the two groups were analyzed. Data related to laboratory examination and clinical outcome. Results compared with the patients without basic diseases, the patients with basic diseases were more likely to develop diffuse lesions (62.9 vs 21.1g / P 0.001g), and the proportion of patients with solid spot and mixed lesions in chest imaging were higher (47.4% vs 16.7%) and 3.33.6% (P 0.05). In addition, the overall mortality of this group of patients was higher than that of 30. 0% vs 5. 3% P0. 016%. Conclusion basic diseases have a significant effect on the clinical symptoms and outcome of patients with NHNT cryptococcosis. NHNT patients with underlying diseases are prone to diffuse lesions, with more severe clinical symptoms and higher overall mortality.
【作者单位】：南京大学医学院附属金陵医院(南京军区南京总医院)呼吸与危重症医学科;
【基金】：国家自然科学基金(81330035)
【分类号】：R519.4

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