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%,P<0.001),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%),P<0.05。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。
Objective Cryptococcosis is a potential life-threatening systemic mycosis with a heterogeneous susceptible popu-lation which is classified into three groups according to the current guidelines, including AIDS patients, organ transplantation recipients （ OTR） , and non-HIV-infected and non-transplant hosts （ NHNT） .This study aimed to discuss the influence of basic diseases on the clinical features and prognosis of NHNT cryptococcosis patients. Methods Using a retrospective cohort study design, we retrieved the clinical data about 73 NHNT cryptococcosis patients treated in Jinling Hospital.Based on the presence or absence of immunodefi-ciency or infection-increasing complications, we divided the patients into a basic disease group （ n=35） and a non-basic disease group （ n=38） and analyzed their clinical characteristics, chest radiographic features, laboratory results, and clinical outcomes. Results Compared with the non-basic disease group, the basic disease group showed a significantly higher incidence rate of disseminated disea-ses （62.9%vs 21.1%, P〈0.01）, more cases of patchy consolidation （47.4%vs 16.7%, P〈0.05） and mixed lesion （31.6%vs 3.3%, P〈0.05） in chest radiography, and a higher mortality （30.0%vs 5.3%, P=0.016）. Conclusion Basic diseases have a great impact on the clinical features and prognosis of NHNT cryptococcosis.NHNT patients with basic diseases are susceptible to dis-seminated diseases with severer clinical symptoms and a higher mortality.
出处
《医学研究生学报》
CAS
北大核心
2015年第7期719-722,共4页
Journal of Medical Postgraduates
基金
国家自然科学基金(81330035)
关键词
隐球菌病
临床特征
基础疾病
预后
Cryptococcosis
Clinical feature
Basic disease
Prognosis
