摘要
目的 探讨肺癌合并侵袭性肺曲霉病（IPA）患者的生存率及死亡危险因素。方法 分析2010年1月～2013年12月在华西医院住院的108例肺癌合并侵袭性肺曲霉病患者的临床资料,随访患者后续治疗情况、死亡原因、死亡时间;并以确诊肺癌合并IPA后12周为随访终点,将患者分为死亡组和存活组,比较两组间临床特征的差异,寻求肺癌合并侵袭性肺曲霉病患者短期内死亡的危险因素。结果 至随访结束,肺癌合并侵袭性肺曲霉病患者共有67人死亡;单因素分析显示：年龄≥60岁（P=0.008）、Ⅳ期肺癌（P=0.004）、合并肺部其他感染（P=0.005）、合并器官衰竭（P=0.009）、粒缺≥Ⅲ级（P=0.032）、全身使用糖皮质激素（P=0.007）、低蛋白血症（P=0.005）、不进行抗曲霉治疗（P=0.028）是肺癌合并侵袭性肺曲霉病患者死亡的危险因素。结论 肺癌合并侵袭性肺曲霉病患者的全因死亡率为62.0%,1年（52周）生存率为39.6%,中位生存期为12周。年龄≥60岁、Ⅳ期肺癌、合并肺部其他感染、合并器官衰竭、粒缺≥Ⅲ级、全身使用糖皮质激素、低蛋白血症、不进行抗曲霉治疗是肺癌合并侵袭性肺曲霉病患者死亡的危险因素。
Objective This study explored the mortality risk factors and survival rate of aspergillosis in patients with lung cancer. Methods This study was the retrospective cohort study, which recruited 108 lung cancer patients with invasive pulmonary aspergillosis hospitalized in West China Hospital between January 1, 2010 and December 31, 2013. The clinical data were collected to understand the general situation, treatment process, treatment reaction of the patients, and patients were followed up for the outcome of treatment, cause and date of death. The clinical characteristics of lung cancer patients complicated with invasive pulmonary aspergillosis were statistical analyzed for the survival situation, risk factors, and prognostic factors. Results All-cause mortality of the lung cancer patients with invasive pulmonary aspergil- losis was 62%. 1 year （52 weeks） survival rate was 39.6%, and the median survival was 12 weeks. The age of 60 years or older （P=0. 008）, stage IV lung cancer （P=0. 004）, pulmonary infection （P=0. 005）, the other organ failure （P= 0. 009）, Class III or IV neutropenia （P=0. 032）, systemic administration of corticosteroids （P=0. 007）, hypoproteine- mia （P=0. 005）, anti-fungal therapy absence （P=0. 028） were the main risks of death in lung cancer patients with inva- sive pulmonary aspergillosis. Conclusion All-cause mortality of the lung cancer patients with invasive pulmonary asper- gillosis was 62%. 1 year （52 weeks） survival rate was 39.6M, and the median survival was 12 weeks. The age of 60 years older, stage IV lung cancer, pulmonary infection, combined with the other organ failure, Class Ⅲ or IV neutrope- nia, systemic administration of corticosteroids, hypoproteinemia, antifungal therapy absence were the risk factors of death for lung cancer patients with invasive pulmonary aspergillosis.
出处
《西部医学》
2016年第1期45-48,共4页
Medical Journal of West China
基金
国家自然科学基金(81201851)
四川省科技厅科技支撑计划项目(2014SZ0231)
关键词
肺癌
侵袭性肺曲霉病
危险因素
生存率
Lung cancer Invasive pulmonary aspergillosis Risk factors Survival rate
