摘要
目的:探讨急性弥漫性肺渗出性病变的病因分布与临床特征。方法:收集武汉大学人民医院2016年11月至2018年11月呼吸重症监护室(RICU)与综合ICU患者的临床资料。患者纳入标准是急性发病、呼吸困难、影像学表现为双肺弥漫性渗出性病变,分析其病因分布与临床特征。结果:急性弥漫性肺渗出性病变患者134例,其中男性75例占56.0%,女性59例占44.0%,年龄(61.8±14.5)岁。发病距就诊时间(10.3±6.8)d,住ICU时间(19.8±10.5)d。病因分布依次为肺部感染87例占64.9%(细菌56例、病毒23例、肺孢子菌16例、其他6例,其中混合感染9例),间质性肺炎15例占11.2%(隐源性机化性肺炎5例、急性间质性肺炎2例、特发性肺纤维化急性加重2例、结缔组织病相关间质性肺病6例)。脓毒血症11例占8.2%,急性左心衰8例占6.0%,吸入性肺炎4例占3.0%。住院死亡38例,病死率28.4%。结论:急性弥漫性肺渗出性病变患者的主要原因为感染,其次为间质性肺炎。感染性患者以细菌、病毒与肺孢子菌感染为主。患者住院病死率较高,住ICU时间较长,应引起高度关注。
Objective:To investigate the etiology and clinical features of acute diffuse infiltrative pulmonary disease.Methods:The data were collected from patients who were hospitalized in repiratory intensive care unit(RICU)and comprehensive ICU of Renmin Hospital of Wuhan University during November2016 to November 2018,and all cases had acute clinical course and respiratory distress with imaging findings of diffuse pulmonary infiltrative shadows.The etiology and clinical features were analyzed.Result:A total of 134 patients with acute diffuse infiltrative pulmonary disease were included,with a mean age of(61.8±14.5)years.Seventy-five(56%)cases were males.The duration of the disease before administration was(10.3±6.8)days,and ICU stay was(19.8±10.5)days.The main cause was infection,which occurred in 87 cases(64.9%)(including bacteria in 56 cases,virus in 23 cases,pneumocystis in 16 cases and others in 6 cases,whereas mixed infections in 9 cases).Interstitial pneumonia occurred in 15 case(11.2%)(including cryptogenic organizing pneumonia in 5 cases,acute interstitial pneumonia in 2 cases,acute exacerbation of idiopathic pulmonary in 2 cases,and connective tissue disease associated interstitial lung disease in 6 cases).Sepsis was found in 11 cases(8.2%),acute left heart failure in 8 cases(6%),and aspiration peneumonia in 4 cases(3%).The hospital mortality was 28.4%.Conclusion:The main cause of acute diffuse infiltrative pulmonary disease is pulmonary infection,and the second common cause is interstitial pneumonia.Infectious patients are mainly infected by bacteria,viruses,and pneumocystis.The hospital mortality is high and ICU stay is long.
作者
索涛
陈国忠
SUO Tao;CHEN Guozhong(Dept.of Respiratory Diseases,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2020年第1期128-132,共5页
Medical Journal of Wuhan University
关键词
弥漫性肺浸润
呼吸困难
感染
间质性肺炎
病因
Diffuse Pulmonary Infiltrative
Respiratory Distress
Infection
Interstitial Pneumonia
Etiology
