Revista clinica espanola最新文献_第2页

Social determinants of health: a priority for internal medicine. Position statement of the Spanish Society of Internal Medicine (SEMI) and the Portuguese Society of Internal Medicine (SPMI) 西班牙内科医学会（SEMI）和葡萄牙内科医学会（SPMI）的立场声明。

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-01-21 DOI: 10.1016/j.rceng.2026.502468

M.M. Chimeno , L. Duarte-Costa , V. Barreto , J.L. Bianchi , L. Campos , J. Araújo-Correia , J. Moreno-Díaz , J.M. Porcel , J. Porto , L. Santos , P. Pérez-Martínez

Introduction

Internal medicine, owing to its comprehensive and cross-sectional approach, is uniquely positioned to lead the integration of social determinants of health (SDOH) into clinical practice.

Methods

Based on the Delphi methodology promoted by the Spanish Society of Internal Medicine (SEMI) and the Portuguese Society of Internal Medicine (SPMI), this study explored perceptions, barriers, and strategies for integrating SDOH into hospital care. Experts from both countries participated in a two-round consultation process, followed by a consensus meeting, which resulted in a prioritized roadmap of action.

Results

Our findings show strong agreement on the relevance of SDOH for health outcomes, the need for mandatory and transversal training at all educational levels, and the importance of validated tools for systematic screening. Key barriers include lack of time, insufficient specific training, limited human resources, and the absence of structured SDOH data in electronic health records. Additionally, the results emphasize the importance of interdisciplinary teams, coordination with social services, and adapting care pathways to patients' social contexts. Emerging determinants include population aging, mental health, climate change, and digital transformation, including artificial intelligence.

Conclusions

This decalogue provides a practical and prioritized roadmap to transform Internal Medicine care towards a more equitable, comprehensive, and SDOH-sensitive model, with training, service organization, technological resources, and collaboration as fundamental pillars.

简介：内科，由于其全面和横断面的方法，是独特的定位，导致健康的社会决定因素（SDOH）整合到临床实践。方法：基于西班牙内科学会（SEMI）和葡萄牙内科学会（SPMI）推广的德尔菲方法，本研究探讨了将SDOH纳入医院护理的认知、障碍和策略。两国专家参加了两轮磋商过程，随后举行了共识会议，制定了优先行动路线图。结果：我们的研究结果表明，SDOH与健康结果的相关性、在所有教育水平上进行强制性和横向培训的必要性以及系统筛查验证工具的重要性是强有力的共识。主要障碍包括缺乏时间、专门培训不足、人力资源有限以及电子健康记录中缺乏结构化的SDOH数据。此外，研究结果强调了跨学科团队、与社会服务机构协调以及使护理途径适应患者社会环境的重要性。新出现的决定因素包括人口老龄化、心理健康、气候变化和包括人工智能在内的数字化转型。结论：本十诫提供了一个实用和优先的路线图，以培训、服务组织、技术资源和合作为基本支柱，将内科护理转变为更公平、全面和对sdoh敏感的模式。

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引用次数: 0

Emergency room visits by older patients living with HIV: an approach based on the EDEN registry 老年艾滋病毒感染者急诊室就诊：一种基于EDEN登记的方法

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-02-02 DOI: 10.1016/j.rceng.2026.502474

Ò. Miró , L. Sentís , M. Carbó , E. Miró , D. Mérida , J.G. del Castillo , en representación del grupo SIESTA

Objective

To investigate the incidence, sociodemographic characteristics, baseline status and evolution of elderly people living with HIV infection (PLHIV) attended in Spanish hospital emergency departments (ED).

Methods

Patients included in the EDEN (Emergency Department and Elder Needs) registry, which includes all patients aged 65 or older attended in 52 Spanish EDs during 7 consecutive days in 2019, were analyzed. Two groups were constructed according to whether or not they had known HIV infection (PLHIV and non-LHIV). We collected 6 sociodemographic factors and 8 referring to the patient's baseline situation. We recorded whether the episode of ED care required hospitalization, intensive care unit (ICU) admission, prolonged ED and inpatient stay, and in-hospital mortality, as well as reconsultation to the ED, rehospitalization, and death from any cause during the 3 years after discharge. The sociodemographic and baseline characteristics and the evolution of patients in the PLHIV and non-PLHIV groups were compared.

Results

Of 25,557 patients in the EDEN registry, 78 were PLHIV (0.30%, 95% CI 0.24% to 0.38%). The annual ED frequentation rate of PLHIV and non-PVHIV was 811 and 573 per 1000 population, respectively. The sociodemographic and baseline conditions were similar between PLHIV and non-PLHIV, with only age differing (younger PLHIV). Older PLHIV had severe comorbidity (27%), some type of functional limitation (27%) and cognitive impairment (11%). The most frequent ED diagnoses in PLHIV were pneumonia or lower respiratory tract infection (11%), heart failure or cardiogenic shock (8%) and joint and axial pain (6%), and in the non-HIV group there were no new diagnoses of HIV infection. 24.4% of PLHIV were hospitalized, 27.3% had a prolonged stay in the ED, 50% had prolonged hospitalization, 7.7% had in-hospital mortality, and reconsultation to the ED, hospitalization, and death during the 3 years post-discharge were 67%, 45.6%, and 21.7%, respectively. No outcome differed between PLHIV and non-PLHIV.

Conclusions

Older PLHIV have sociodemographic and baseline characteristics like the general population, but their rate of ED visits is higher. The severity of the episodes leading to this ED consultation is similar between PLHIV and non-PLHIV and long-term follow-up also shows no differences.

目的：了解西班牙医院急诊科（ED）老年人HIV感染（PLHIV）的发生率、社会人口学特征、基线状况及其演变。方法：对EDEN（急诊科和老年人需求）登记处的患者进行分析，该登记处包括2019年连续7天在52个西班牙急诊科就诊的所有65岁及以上患者。根据是否已知HIV感染分为PLHIV和non-LHIV两组。我们收集了6个社会人口学因素和8个涉及患者基线情况的因素。我们记录了在出院后的3年内，急诊科的发作是否需要住院、重症监护病房（ICU）入院、延长急诊科和住院时间、住院死亡率、再咨询急诊科、再住院和任何原因死亡。比较PLHIV组和非PLHIV组患者的社会人口学特征和基线特征及其演变。结果：在EDEN登记的25557例患者中，78例为PLHIV （0.30%, 95% CI 0.24%至0.38%）。PLHIV和非pvhiv的ED年发病率分别为811 / 1000和573 / 1000。PLHIV和非PLHIV之间的社会人口学和基线条件相似，只是年龄不同（年轻的PLHIV）。老年PLHIV患者有严重的合并症（27%），某种类型的功能限制（27%）和认知障碍（11%）。PLHIV患者中最常见的ED诊断为肺炎或下呼吸道感染（11%）、心力衰竭或心源性休克（8%）、关节和轴性疼痛（6%），而非HIV组中没有新的HIV感染诊断。24.4%的PLHIV患者住院，27.3%的患者在急诊科长时间住院，50%的患者长时间住院，7.7%的患者住院死亡，出院后3年内再诊、住院和死亡的比例分别为67%、45.6%和21.7%。PLHIV和非PLHIV之间没有结果差异。结论：老年hiv患者具有与普通人群相似的社会人口学特征和基线特征，但其急诊科就诊率较高。在PLHIV和非PLHIV患者中，导致ED会诊的发作的严重程度相似，长期随访也没有差异。

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引用次数: 0

GRADE methodology in consensus and clinical practice guidelines for the management of retinal vein occlusion GRADE方法在视网膜静脉闭塞治疗的共识和临床实践指南。

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-02-02 DOI: 10.1016/j.rceng.2026.502469

C. Burgueño-Montañes , R. Bouchikh-El Jarroudi , M. Zavaleta-Mercado , J. Galvez-Olortegui

引用次数: 0

Reply to: Start of sodium-glucose cotransporter type 2 inhibitors (iSGLT2) in patients with acute heart failure in the Emergency room? 急诊室急性心力衰竭患者开始使用钠-葡萄糖共转运蛋白2型抑制剂（iSGLT2）？

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.rceng.2026.502484

Pere Llorens

引用次数: 0

Baseline treatment with beta-blockers and renin-angiotensin system inhibitors and their association with adverse events in acute heart failure -受体阻滞剂和肾素-血管紧张素系统抑制剂的基线治疗及其与急性心力衰竭不良事件的关联。

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.rceng.2026.502487

Antoni Haro , Javier Jacob , Xavier Rossello , Aitor Alquezar-Arbe , Pere Llorens , Òscar Miró , en representación del grupo ICASEMES

Introduction

Baseline treatment with beta-blockers (BB) and/or renin-angiotensin system inhibitors (RASi) has been extensively studied in the context of heart failure, given its fundamental role in modulating the neurohormonal axis and improving survival.

Objective

To investigate whether there is an association between receiving baseline treatment with BB or RASi, either alone or in combination, and the short-term prognosis of an episode of acute heart failure (AHF).

Method

Patients from the EAHFE registry (Epidemiology of Acute Heart Failure in Spanish Emergency Departments) were analyzed. This is a multicenter, prospective, multipurpose registry that collects all AHF episodes presenting to participating hospital emergency departments (EDs) over a period of 1–2 months between 2007 and 2018. The primary outcome variable investigated was in-hospital all-cause mortality during the ED stay or hospitalization. Adjusted analyses were conducted using multiple logistic regression and multiple imputation to control for potential confounding factors.

Results

The study included a total of 17,916 episodes of acute heart failure (AHF). A total of 26.2% of patients did not receive treatment with either beta-blockers (BB) or renin–angiotensin system inhibitors (RASi), constituting the reference group. Overall, 17.8% of patients received BB only, 30.4% were treated exclusively with RASi, and 25.7% received a combination of both drugs. The mean age of the patients was 80.4 years (standard deviation 10.2 years), and 55.7% were women. In-hospital mortality was 7.3%. After multivariable adjustment, a significant association with lower mortality was found for treatment with BB alone (odds ratio [OR] = 0.826, 95% confidence interval [CI] 0.685–0.996), OR = 0.709 (CI95% 0.600−0.837) RASi alone and for combined treatment with RASi and BB (OR = 0.699, 95%CI 0.580–0.843). In the adjusted model with multiple imputation, the results remained significant.

Conclusions

In patients with an episode of AHF, baseline treatment with BB, RASi, or both is associated with lower all-cause mortality. This association is strongest in the group of patients receiving both treatments combined, and the results remain significant after multivariate adjustment.

导论：鉴于β受体阻滞剂（BB）和/或肾素-血管紧张素系统抑制剂（RASi）在调节神经激素轴和提高生存率方面的基本作用，在心力衰竭的背景下，对其进行了广泛的研究。目的：探讨在基线治疗中单独或联合使用BB或RASi与急性心力衰竭（AHF）发作的短期预后之间是否存在关联。方法：对西班牙急诊科急性心力衰竭流行病学（EAHFE）登记的患者进行分析。这是一个多中心、前瞻性、多用途的登记，收集了2007年至2018年1至2个月期间在参与医院急诊科（ed）就诊的所有AHF事件。调查的主要结局变量是急诊科住院或住院期间的院内全因死亡率。采用多元逻辑回归和多元归算进行校正分析，以控制潜在的混杂因素。结果：该研究共包括17,916例急性心力衰竭（AHF）发作。共有26.2%的患者未接受β受体阻滞剂（BB）或肾素-血管紧张素系统抑制剂（RASi）的治疗，构成参照组。总体而言，17.8%的患者仅接受BB治疗，30.4%的患者仅接受RASi治疗，25.7%的患者接受两种药物联合治疗。患者平均年龄80.4岁（标准差10.2岁），女性55.7%。住院死亡率为7.3%。多变量调整后，发现单独使用BB治疗与较低的死亡率有显著相关性（优势比[OR] = 0.826, 95%可信区间[CI] 0.685-0.996），单独使用RASi治疗与联合使用RASi和BB治疗（OR = 0.699, 95%可信区间[CI] 0.600-0.837）。在多次插值调整后的模型中，结果仍然显著。结论：在AHF发作的患者中，BB、RASi或两者的基线治疗与较低的全因死亡率相关。这种相关性在同时接受两种治疗的患者组中最强，并且在多因素调整后结果仍然显著。

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引用次数: 0

Current situation and role of internists in healthcare ethics committees in Spain. PANACEAS study 西班牙内科医生在医疗伦理委员会中的现状和作用。灵丹妙药。

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-02-02 DOI: 10.1016/j.rceng.2026.502483

Durán del Campo P. , Solano Iturri G. , Alonso Ortiz B. , Bertran Muñoz J. , Bravo Blanco A.M. , Briongos Figuero L. , Carrera García C. , Chacón Moreno A.D. , Blanco Portillo A. , Galván-Román J.M.

Objectives

To analyze the current situation of Healthcare Ethics Committees (HECs) in Spain, their composition and functions, as well as the implementation of Clinical Ethics Consultancy (CEC). Finally, to assess the involvement of internists in HECs.

Materials and methods

A cross-sectional descriptive study conducted through a self-administered online survey distributed between February and May 2025 to all identified HECs in the country.

Results

A total of 112 HECs (47.66%) out of the 235 accredited nationwide participated. The average number of members per committee was 16 (range: 6–29). The most represented professional profiles were nursing and medicine. In 99.1% of the committees, at least one member had postgraduate training in Bioethics. The most frequent range of meetings per year was between 7 and 12 (46.8%). Most HECs (91.1%) were involved in educational activities, and 58% had produced ethical documents. The majority reviewed between 1 and 5 cases annually (69.6%). The CEC role was established in 40.2% of HECs and in the process of implementation in 18.8%. Internists were present in 54% of HECs. In 65% of cases, the internist is part of the CEC.

Conclusions

HECs in Spain demonstrate significant involvement in educational activities and the development of ethical documents; however, they receive a relatively low number of annual consultations. Clinical Ethics Consultancy is gradually being integrated into the structure of HECs, which may enhance the management of ethical inquiries. Internists are members of more than half of the HECs and play a very active role in their operations.

目的：分析西班牙医疗伦理委员会（HECs）的现状、组成和职能，以及临床伦理咨询（CEC）的实施情况。最后，评估内科医生参与高等专科医院的情况。材料和方法：一项横断面描述性研究，通过一项自我管理的在线调查进行，该调查于2025年2月至5月分发给全国所有确定的hec。结果：在全国235家经认证的高等学校中，共有112家（47.66%）参与。每个委员会的平均成员人数为16人（范围：6-29人）。最具代表性的专业是护理和医学。在99.1%的委员会中，至少有一名成员接受过生物伦理学研究生培训。每年最频繁的会议范围是7至12次（46.8%）。大多数高等学校（91.1%）参与了教育活动，58%的高等学校制定了伦理文件。大多数病例每年复查1 - 5例（69.6%）。40.2%的高等教育中心确立了中央协调委员会的作用，18.8%的高等教育中心处于执行过程中。内科医生出现在54%的hec中。在65%的病例中，内科医生是CEC的一部分。结论：西班牙的高等教育机构在教育活动和道德文件的制定方面表现出了显著的参与；但是，他们每年接受的咨询次数相对较少。临床伦理咨询正逐渐纳入高等医院的架构，这可能会加强对伦理咨询的管理。内科医生是超过一半的高等医疗保健委员会的成员，在这些委员会的运作中发挥着非常积极的作用。

{"title":"Current situation and role of internists in healthcare ethics committees in Spain. PANACEAS study","authors":"Durán del Campo P. , Solano Iturri G. , Alonso Ortiz B. , Bertran Muñoz J. , Bravo Blanco A.M. , Briongos Figuero L. , Carrera García C. , Chacón Moreno A.D. , Blanco Portillo A. , Galván-Román J.M.","doi":"10.1016/j.rceng.2026.502483","DOIUrl":"10.1016/j.rceng.2026.502483","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the current situation of Healthcare Ethics Committees (HECs) in Spain, their composition and functions, as well as the implementation of Clinical Ethics Consultancy (CEC). Finally, to assess the involvement of internists in HECs.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional descriptive study conducted through a self-administered online survey distributed between February and May 2025 to all identified HECs in the country.</div></div><div><h3>Results</h3><div>A total of 112 HECs (47.66%) out of the 235 accredited nationwide participated. The average number of members per committee was 16 (range: 6–29). The most represented professional profiles were nursing and medicine. In 99.1% of the committees, at least one member had postgraduate training in Bioethics. The most frequent range of meetings per year was between 7 and 12 (46.8%). Most HECs (91.1%) were involved in educational activities, and 58% had produced ethical documents. The majority reviewed between 1 and 5 cases annually (69.6%). The CEC role was established in 40.2% of HECs and in the process of implementation in 18.8%. Internists were present in 54% of HECs. In 65% of cases, the internist is part of the CEC.</div></div><div><h3>Conclusions</h3><div>HECs in Spain demonstrate significant involvement in educational activities and the development of ethical documents; however, they receive a relatively low number of annual consultations. Clinical Ethics Consultancy is gradually being integrated into the structure of HECs, which may enhance the management of ethical inquiries. Internists are members of more than half of the HECs and play a very active role in their operations.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"226 3","pages":"Article 502483"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to: GRADE methodology in consensus and clinical practice guidelines for the management of retinal vein occlusion 对视网膜静脉闭塞治疗的共识和临床实践指南中的GRADE方法的回应。

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.rceng.2026.502482

J. Pagán Escribano

引用次数: 0

Educational level as a moderator of the relationship between body mass index, blood pressure, and depressive symptoms in the Peruvian population: a moderated mediation analysis 秘鲁人口中受教育程度对体重指数、血压和抑郁症状之间关系的调节作用：一项有调节的中介分析

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.rceng.2026.502473

A. Guevara-Tirado

Objective

To analyse whether systolic blood pressure influences the relationship between body mass index and depressive symptoms, and whether educational level moderates these associations in Peruvian adults.

Methods

Cross-sectional study using data from the Peruvian Demographic and Health Survey (ENDES). Individuals aged ≥15 years were included. Depression was assessed with the PHQ-9 (continuous score); BMI and SBP were treated as continuous variables. A moderated mediation model (PROCESS model 59) was applied, adjusting for alcohol consumption, age, mother tongue, ethnic identity, and marital status.

Results

In the moderated analysis, BMI showed a positive association with SBP (B = 0.61; 95% CI: 0.57–0.66), with a stronger effect in individuals with higher education (B = 0.81) compared to those with basic education (B = 0.61). Alcohol consumption (B = 1.20), speaking an indigenous mother tongue (B = 1.26), and age (B = 0.42 per year) were associated with higher SBP, while living with a partner was protective (B = −2.05). In the model for depressive symptoms, BMI (B = 0.04) and SBP (B = 0.02) increased PHQ-9 scores; the effect of SBP was greater among higher-educated individuals (B = 0.036) than those with basic education (B = 0.022). The moderated mediation showed that the indirect component via SBP was higher in individuals with higher education (B = 0.081) than in those with basic education (B = 0.035), with a moderated mediation index of 0.040 (95% CI: 0.028–0.052).

Conclusions

Educational level modulates the relationship between BMI, blood pressure, and depression, highlighting health inequalities that can inform public health strategies and prevention policies.

目的：分析收缩压是否影响体重指数与抑郁症状之间的关系，以及秘鲁成年人的教育水平是否调节了这些关系。方法：利用秘鲁人口与健康调查（ENDES）的数据进行横断面研究。纳入年龄≥15岁的个体。用PHQ-9（连续评分）评估抑郁；BMI和收缩压作为连续变量处理。采用有调节的中介模型（PROCESS模型59），对饮酒、年龄、母语、种族认同和婚姻状况进行了调整。结果：在适度分析中，BMI与收缩压呈正相关（B = 0.61; 95% CI: 0.57-0.66），且高等教育个体（B = 0.81）比基础教育个体（B = 0.61）的影响更强。饮酒（B = 1.20）、说当地母语（B = 1.26）和年龄（B = 0.42 /年）与较高的收缩压相关，而与伴侣生活在一起则具有保护作用（B = -2.05）。在抑郁症状模型中，BMI （B = 0.04）和收缩压（B = 0.02）使PHQ-9得分升高；高学历人群（B = 0.036）对收缩压的影响大于基础学历人群（B = 0.022）。经调节的中介结果显示，高学历人群（B = 0.081）的间接成分高于基础学历人群（B = 0.035），调节的中介指数为0.040 （95% CI: 0.028 ~ 0.052）。结论：教育水平调节BMI、血压和抑郁之间的关系，强调健康不平等，可以为公共卫生战略和预防政策提供信息。

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引用次数: 0

Procalcitonin and midregional proadrenomedullin (MR-proADM) could help make home hospitalization of patients seen for suspected infection in the Emergency department safer 降钙素原和中部肾上腺髓质素原（MR-proADM）可使在急诊科就诊的疑似感染患者更安全地在家住院。

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-02-02 DOI: 10.1016/j.rceng.2026.502472

J. Cabañas Morafraile , L.S. Martín , E. de Rafael González , A. Julián-Jiménez , En nombre del grupo URGEN-LABQMIC del CHUT del Instituto de Investigación Sanitaria de Castilla La Mancha (IDISCAM)

引用次数: 0

Evolution of radiologic alterations in patients unvaccinated with COVID-19 pneumonia and prediction of lung fibrosis development at 6 months according to predictive model 基于预测模型的未接种covid-19肺炎患者放射学改变演变及6个月肺纤维化发展预测

Revista clinica espanola

Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.rceng.2026.502488

S. Cuenca Peris , M. Marín Royo , S.F. Marco Domenech

Introduction

Alteration in pulmonary function tests and radiological abnormalities are present in a significant percentage of COVID-19 survivors. Our aim is to evaluate radiological findings and functional respiratory parameters involved in lung fibrosis at six months after SARS-CoV-2 pneumonia and use initial score of the predictive model to predict fibrotic-like changes at 6 months.

Material and methods: Prospective observational study including unvaccinated patients with COVID-19 pneumonia. Pulmonary function tests and chest CT were performed six months after acute pneumonia.

Results

109 patients were included. Bilateral ground-glass opacities (94%) were the most frequent radiological finding, followed by bilateral consolidations (36%) and crazy paving patterns (28%). Ct tracking shows a significant decrease in bilateral ground glass, consolidations and bilateral crazy paving at 6 months. In contrast, architectural distortion tends to increase over time. The presence of bronchial dilatation, subpleural curved line and parenchymal bands on initial CT were associated with radiological signs of lung fibrosis at 6 months. An initial score of the predictive model >0.6 predicts fibrotic-like changes at 6 months (AUC 77.8%; Specificity 85.4%; Sensitivity 58.1%). The proportion of patients with DLCO <80% was 55%.

Conclusions

In 50 patients, 6 months CT detected signs of fibrotic-like changes. The presence of bronchial dilatation, subpleural curved line and parenchymal bands could be used as early predictors of fibrotic-like changes in patients with COVID-19 pneumonia. Initial score of the predictive model >0,6 allows the selection of patients at risk of developing pulmonary fibrotic-like changes. DLCO was the one most frequently impaired at 6 months.

在很大比例的COVID-19幸存者中存在肺功能检查改变和影像学异常。我们的目的是评估SARS-CoV-2肺炎后6个月与肺纤维化相关的影像学表现和功能呼吸参数，并使用预测模型的初始评分来预测6个月时的纤维化样变化。材料和方法：前瞻性观察研究，纳入未接种疫苗的COVID-19肺炎患者。急性肺炎后6个月进行肺功能检查和胸部CT检查。结果：纳入109例患者。双侧磨玻璃混浊（94%）是最常见的影像学表现，其次是双侧实变（36%）和疯狂铺路模式（28%）。Ct跟踪显示，6个月时双侧磨玻璃、固结、双侧狂铺明显减少。相反，随着时间的推移，体系结构的扭曲倾向于增加。最初CT上支气管扩张、胸膜下弯曲线和实质带的出现与6个月时肺纤维化的影像学征象有关。预测模型初始评分> 0.6预测6个月时的纤维样改变（AUC 77.8%，特异性85.4%，敏感性58.1%）。结论：在50例患者中，6个月CT检测到纤维样改变征象。支气管扩张、胸膜下曲线和实质带的存在可作为COVID-19肺炎患者纤维化样改变的早期预测指标。预测模型> 0,6的初始评分允许选择有发生肺纤维化样改变风险的患者。DLCO在6个月时最常受损。

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引用次数: 0