特发性肺纤维化患者相关预后影响因素的临床研究

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(P0.05);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。

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

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.