解放军医学院学报2023，Vol.44Issue(12)：1357-1363,1371,8.DOI:10.12435/j.issn.2095-5227.2023.128
肺毛霉病临床特征及预后因素的多中心回顾性分析
Clinical features and prognostic factors of pulmonary mucormycosis:A multicenter retrospective analysis
尹艾若 1王海燕 2苑鑫 3韩志海 4崔俊昌5
作者信息
- 1. 解放军总医院第八医学中心呼吸与危重症医学部,北京 100091||解放军医学院,北京 100853
- 2. 解放军总医院第四医学中心呼吸与危重症医学科,北京 100142
- 3. 解放军总医院第五医学中心呼吸与危重症医学科,北京 100071
- 4. 解放军总医院第六医学中心呼吸与危重症医学科,北京 100037
- 5. 解放军总医院第八医学中心呼吸与危重症医学部,北京 100091
- 折叠
摘要
Abstract
Background Pulmonary mucormycosis(PM)is a rare but high mortality fungal infection,and relatively few clinical studies of PM have been conducted at home and abroad.Objective To analyze the clinical features of PM and the risk factors affecting prognosis,and improve the understanding of PM.Methods Clinical data about 46 patients with PM admitted to five medical centers of Chinese PLA General Hospital from January 2001 to March 2023 were retrospectively analyzed,and the clinical outcomes of patients with pulmonary mucormycosis were assessed at 90 days after diagnosis.Patients were divided into survival group and death group,and the covariates screened by a combination of univariate analysis,Lasso regression,and random forests were included in multifactorial logistic regression to analyze the factors related to PM prognosis.Results A total of 46 patients with PM were included,the median age was 53.5(range:2-81)years,35(76％)cases were male.Diabetes mellitus and hematological malignant tumors were the main underlying diseases,clinical symptoms were mainly manifested as coughing and sputum and fever,the main imaging manifestations were solid lesions,nodules,cavities and pleural effusion.Sixteen cases died,with the mortality rate of 35％.Endotracheal intubation and respiratory-assisted respiration(OR=21.102,95％CI:2.058 to 216.397)was an independent risk factor for PM prognosis,while taking surgical treatment(OR=0.043,95％CI:0.003 to 0.695)was an independent protective factor for PM prognosis.Conclusion PM often occurs in patients with diabetes mellitus and hematological malignancies with nonspecific clinical features and imaging manifestations,and early initiation of surgical and anti-Mucor therapy is the key to improving patients'prognosis.关键词
肺毛霉病/预后/临床特征/免疫抑制/宏基因组下一代测序Key words
pulmonary mucormycosis/prognosis/clinical features/immunosuppression/metagenomic next-generation sequencing分类
医药卫生引用本文复制引用
尹艾若,王海燕,苑鑫,韩志海,崔俊昌..肺毛霉病临床特征及预后因素的多中心回顾性分析[J].解放军医学院学报,2023,44(12):1357-1363,1371,8.
