特发性肺纤维化患者相关预后影响因素的临床研究

Clinical Study on Related Factors Affecting Prognosis of Patients with Idiopathic Pulmonary Fibrosis

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＆lt;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.