特发性肺纤维化患者相关预后影响因素的临床研究

摘要

目的：探讨临床相关指标、肺组织病生理变化、中医证候积分等因素对特发性肺纤维化（IPF）患者预后的影响价值。方法：经临床诊断的48例IPF患者行呼吸困难评分、肺功能和动脉血气检测。采用Kaplan-Meier检验比较组间生存率，采用Cox比例风险回归评价各指标的死亡风险度。结果：在平均随访37个月内，IPF患者诊断后的中位生存期为37.35个月。单因素Cox比例风险回归分析提示：中医证候积分、体重指数、6分钟步行试验、肺功能中的FVC％、TLC％、DLCO％、血气分析中的PO2、血沉、杵状指是影响特发性肺纤维化患者预后的因素（P＜0.05）；多因素Cox比例风险回归分析显示：体重指数、6分钟步行试验、血沉是IPF患者预后的主要影响因素。结论：体重指数、中医证候积分、6分钟步行试验、肺功能中TLC％、DLCO％、血气分析中PO2、血沉、杵状指是IPF患者预后的影响因素，其中体重指数、6分钟步行试验、血沉是主要影响因素。%Objective:To investigate effects of relevant factors including clinical implications,lung disease and physiological variables and TCM syndrome integral on the prognosis of patients with idiopathic pulmonary fibrosis (IPF).Methods:Forty-eight patients with IPF according to clinical diagnosis underwent dyspnea score,pulmonary function tests and arterial blood gas test.The Kaplan-Meier test was used to estimate the survival rate in the two groups,and Coxproportional hazard regression was taken to evaluate Hazard Ratio in the IPF patients.Results:During the37 months of follow-up,the median survival time was 37.35 months after diagnosis.The univariate Cox pro-portional hazards regression analysis showed that TCMsyndrome integral,BMI,6 minutes walk test and FVC%,TLC%,DLCO%,PO2, ESR,clubbing fingers were the factors affected the prognosis of patients with IPF (P<0.05 ).The multivariate Cox proportional hazards regression analysis showed that BMI,6 minutes walk test,ESR were the main influence factors for the prognosis of patients with IPF.Con-clusion:BMI,TCM syndrome integral,6 minutes walk test and TLC %,DLCO %,PO2 ,ESR,clubbing fingers were the influence factors of the prognosis of patients with IPF,among which the BMI,6 minutes walk test,ESR were the main influence factors.