摘要
目的观察接受吡非尼酮联合氧疗的老年特发性肺纤维化(IPF)患者的临床特征,并总结影响其治疗效果的因素。方法回顾性分析2015年1月—2019年12月在重庆市中医院等医院住院治疗的59例老年IPF患者的临床资料。所有患者采取吡非尼酮联合氧疗治疗。收集患者入院时治疗前的相关资料,分析其与患者结局的相关性。以患者在2019年12月1日前死亡率作为主要结局,并以患者急性发作次数作为次要结局。结果治疗中有6例患者因不能耐受或不良反应而退出,最后纳入54例患者,Poisson回归表明患者的年龄、吸烟史、FEV1%、FVC%、IPF分期、GAP指数、HRCT评分与患者的急性发作次数相关(P<0.05);单因素回归分析发现年龄、吸烟史、FEV1%、DLco%、IPF分期、D-二聚体、SP-D与患者生存时间相关(P<0.05);多因素回归分析表明年龄(HR 1.82,95%CI 1.56~1.87)、FEV1%(HR 1.77,95%CI 1.49~1.90)、DLco%(HR 1.47,95%CI 1.33~1.81)、吸烟史(HR 1.26,95%CI 1.16~1.63)、IPF分期(HR 1.45,95%CI 1.24~1.51)、D-二聚体(HR 1.13,95%CI 1.10~1.28)、SP-D(HR 1.23,95%CI 1.01~1.48)与患者生存时间相关(P<0.01)。结论年龄、吸烟史、FEV1%、IPF分期与患者急性发作次数及生存时间均相关,而FVC%、GAP指数、HRCT评分仅与急性发作次数相关,DLco%、D-二聚体、SP-D仅与患者生存时间相关。
Objective To observe the clinical characteristics of elderly patients with idiopathic pulmonary fibrosis(IPF)receiving pirfenidone combined with oxygen therapy,and to summarize the factors influencing the therapeutic effect.Methods The clinical data of 59 elderly patients with IPF admitted to Traditional Chinese Medicine Hospital of Chongqing City from January 2015 to December 2019 were retrospectively analyzed.All patients were treated with pirfenidone combined with oxygen therapy.The relevant data before treatment at admission were collected,and their correlation with the outcome of patients were analyzed.The mortality of the patient before December 1,2019 was the main outcome,and the number of acute attacks was the secondary outcome.Results During the treatment,6 patients withdrew because of intolerance or adverse reactions,and finally 54 patients were included.Poisson regression showed that the patient’s age,smoking history,FEV1%,FVC%,IPF stage,GAP index,HRCT score were correlated with the number of acute attacks(P<0.05);univariate regression analysis showed that age,smoking history,FEV1%,DLco%,IPF staging,D-dimer,SP-D were related to patient survival time(P<0.05);multivariate regression analysis showed that age(HR 1.82,95%CI 1.56~1.87),FEV1%(HR 1.77,95%CI 1.49~1.90),DLco%(HR 1.47,95%CI 1.33~1.81),smoking history(HR 1.26,95%CI 1.16~1.63),IPF staging(HR 1.45,95%CI 1.24~1.51),D-dimer(HR 1.13,95%CI 1.10~1.28),SP-D(HR 1.23,95%CI 1.01~1.48)were related to patient survival time(P<0.01).Conclusion Age,smoking history,FEV1%,IPF staging are related to the number of acute attacks and survival time;the FVC%,GAP index,and HRCT score are only related to the number of acute attacks;DLco%,D-dimer,SP-D are only related to patient survival time.
作者
熊恩平
何月霞
熊燕
姚伟
Xiong Enping;He Yuexia;Xiong Yan;Yao Wei(Department of Respiratory,Traditional ChineseMedicine Hospital of Chongqing City,Chongqing,400021,P.R.China;Department of Thoracic Surgery,Second Affiliated Hospital of Third Military Medical University of PLA,Chongqing,400021,P.R.China;Department ofOncology,Traditional ChineseMedicineHospital of Chongqing City,Chongqing,400021,P.R.China;Department of Respiratory Medicine,Third Affiliated Hospital of Chongqing Medical University,Chongqing,401120,P.R.China.)
出处
《老年医学与保健》
CAS
2020年第4期559-562,共4页
Geriatrics & Health Care
关键词
老年
特发性肺纤维化
预后
生存分析
elderly
idiopathic pulmonary fibrosis
prognosis
survival analysis
