特发性支气管扩张症患者支气管动脉栓塞术后复发咯血的独立风险因素:一项回顾性队列研究。

IF 5.8 2区 医学 Q1 Medicine Respiratory Research Pub Date : 2024-10-26 DOI:10.1186/s12931-024-03019-2
Jibo Sun, Xiang Tong, Dongguang Wang, Lian Wang, Shijie Zhang, Sitong Liu, Xiu Li, Qingqing Jia, Jiehao Chen, Yao Ma, Hong Fan
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引用次数: 0

摘要

背景:目前,缺乏对支气管扩张相关咯血中多重耐药铜绿假单胞菌(MDR-PA)分离的研究。本研究旨在分析支气管动脉栓塞术(BAE)后复发性咯血的风险因素,并比较MDR-PA、非MDR-PA和非PA分离术的无复发性咯血率:一项回顾性研究针对在大学附属医院接受 BAE 的特发性支气管扩张相关复发性咯血患者。根据 PA 药敏试验将患者分为非 PA 组、非 MDR-PA 组和 MDR-PA 组。通过单变量和多变量考克斯回归来确定复发性咯血的独立风险因素。采用 Kaplan-Meier 曲线比较非 PA、非 MDR-PA 和 MDR-PA 患者 BAE 后的无复发性咯血率:结果:共纳入 432 例患者。181例(41.90%)患者在中位 25 个月的随访期间出现复发性咯血。MDR-PA 分离(调整后危险比 (aHR) 2.120; 95% 置信区间 (CI) [1.249, 3.597], p = 0.005)被确定为复发性咯血的独立危险因素。抗生素治疗(aHR 0.666;95% CI [0.476,0.932],p = 0.018)降低了复发性咯血的风险。非 MDR-PA、非 MDR-PA 和 MDR-PA 的累计无复发性咯血率如下:3 个月时,分别为 88.96%、88.24% 和 75.86%;1 年时,分别为 73.13%、69.10% 和 51.72%;3 年时,分别为 61.91%、51.69% 和 41.10%(P = 0.034):结论:MDR-PA 分离是急性呼吸衰竭后复发性咯血的独立风险因素。减少 MDR-PA 的发生可有效降低咯血的复发率。
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Multi-drug resistant Pseudomonas aeruginosa isolation is an independent risk factor for recurrent hemoptysis after bronchial artery embolization in patients with idiopathic bronchiectasis: a retrospective cohort study.

Background: Currently, there is a lack of research on multi-drug resistant Pseudomonas aeruginosa (MDR-PA) isolation in bronchiectasis-related hemoptysis. The aim of this study to analyze the risk factors for recurrent hemoptysis following bronchial artery embolization (BAE) and compare the recurrent hemoptysis-free rates between MDR-PA, non-MDR-PA, and non-PA isolation.

Methods: A retrospective study was performed of patients diagnosed with idiopathic bronchiectasis-related recurrent hemoptysis who underwent BAE at an university-affiliated hospital. Patients were categorized based on PA susceptibility tests into non-PA, non-MDR-PA, and MDR-PA groups. Univariate and multivariate Cox regression were conducted to identify independent risk factors for recurrent hemoptysis. The Kaplan-Meier curves was conducted to compare recurrent hemoptysis-free rates after BAE for non-PA, non-MDR-PA, and MDR-PA.

Results: A total of 432 patients were included. 181 (41.90%) patients experienced recurrent hemoptysis during a median follow-up period of 25 months. MDR-PA isolation (adjusted hazard ratio (aHR) 2.120; 95% confidence interval (CI) [1.249, 3.597], p = 0.005) was identified as an independent risk factor for recurrent hemoptysis. Antibiotic treatment (aHR 0.666; 95% CI [0.476, 0.932], p = 0.018) reduced the risk of recurrent hemoptysis. The cumulative recurrent hemoptysis-free rates for non-PA, non-MDR-PA, and MDR-PA were as follows: at 3 months, 88.96%, 88.24%, and 75.86%, respectively; at 1 year, 73.13%, 69.10%, and 51.72%; and at 3 years, 61.91%, 51.69%, and 41.10% (p = 0.034).

Conclusion: MDR-PA isolation was an independent risk factor of recurrent hemoptysis post-BAE. Reducing the occurrence of MDR-PA may effectively decrease the recurrence rates of hemoptysis.

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来源期刊
Respiratory Research
Respiratory Research RESPIRATORY SYSTEM-
CiteScore
9.70
自引率
1.70%
发文量
314
审稿时长
4-8 weeks
期刊介绍: Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases. As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion. Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.
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