河北医科大学学报

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非HIV免疫抑制巨细胞病毒肺炎患者合并感染情况分析

  

  1. 河北医科大学第二医院呼吸与危重病医学二科,河北 石家庄 050000
  • 出版日期:2019-12-25 发布日期:2019-12-26
  • 作者简介:潘文森(1974-),男,河北景县人,河北医科大学第二医院主任医师,医学博士,从事呼吸危重症诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题(20170602)

Analysis of co-infection in non-HIV immunosuppressed patients with cytomegalovirus pneumonia#br#

  1. The Second Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
  • Online:2019-12-25 Published:2019-12-26

摘要: [摘要]
  目的  分析非获得性免疫缺陷病毒(human immunodeficiency virus,HIV)免疫抑制患者罹患巨细胞病毒肺炎合并感染的特点,为临床治疗提供参考。
  方法  回顾性分析68例非HIV免疫抑制患者巨细胞病毒肺炎患者的一般临床资料和合并感染的病原学资料。
  结果  68例患者均为非HIV感染患者,免疫抑制为应用糖皮质激素或者免疫抑制剂所致,基础疾病为肾脏疾病、风湿性疾病、血液系统疾病,合并疾病者也非常多见;超过70%患者为混合感染,合并有细菌、真菌或其他病原体感染。患者总体病死率较高(33.82%)。因皮肤疾病应用药物所致免疫抑制患者病死率较高,合并疾病在死亡患者更为多见;肺部合并革兰阳性球菌感染或发生血流感染者预后更差。
  结论  肾脏疾病、风湿性疾病、血液系统疾病并接受糖皮质激素或免疫抑制剂治疗的患者,容易发生巨细胞病毒肺炎且总体病死率较高。因皮肤疾病应用药物所致免疫抑制患者或合并其他疾病者、肺部合并革兰阳性球菌感染或发生血流感染者病死率较高。

关键词: 巨细胞病毒感染, 肺炎, 免疫抑制

Abstract: [Abstract]Objective〖HTSS〗To analyze the co-infection characteristics of non-human immunodeficiency virus(HIV) immunosuppressed patients with cytomegalovirus pneumonia, so as to provide reference for clinical treatment.
  〖WTHZ〗Methods〖HTSS〗A retrospective case analysis study was used. The data of general condition and co-infection characteristic of 68 patients with cytomegalovirus pneumonia were collected.
  〖WTHZ〗Results〖HTSS〗All of 68 patients were non-HIV infected and were treated with corticosteroids or immunosuppressants for underlying diseases including kidney disease, rheumatic disease, and blood system disease. And most of these patients had complications. More than 70% of the 68 patients had co-infections, including bacterial, fungal, or other atypical pathogen. The overall hospital mortality rate was 33.82%. The immunosuppressed patients who suffered from dermatological disease or had co-morbidity, and patients who had G+ pneumonia or bloodstream infections also had a poor prognosis(P<0.05).
  〖WTHZ〗Conclusion〖HTSS〗Among patients with cytomegalovirus pneumonia secondary to non-HIV infection,autoimmune system diseases after corticosteroids or immunosuppressants treatment are the most common primary diagnosis, with poor prognosis. Patients who suffered from dermatological disease, with co-morbidity or G+ pneumonia, and or bloodstream infections had a poorer prognosis.

Key words: cytomegalovirus infections, pneumonia, immunosuppression