对肺部浸润的免疫功能低下患者进行柔性支气管镜检查的诊断率:单中心回顾性研究

IF 2.4 Q2 RESPIRATORY SYSTEM
Natsuki Nakagawa, Takahiro Ando, Masanori Kawakami, Keisuke Hosoki, Yoshihisa Hiraishi, Yu Mikami, Hidenori Kage
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引用次数: 0

摘要

背景肺部并发症与免疫功能低下患者的死亡率有关。支气管镜检查的作用已有报道。材料和方法 我们回顾性分析了对 108 名免疫功能低下患者(定义为服用皮质类固醇和/或免疫抑制剂的患者)进行的 115 次支气管镜检查。我们对支气管镜检查的临床因素、取样程序、最终诊断和严重并发症进行了评估。其中,33 例被诊断为感染性疾病,18 例为非感染性疾病。115 例患者中有 9 例(7.8%)因支气管镜检查的微生物学结果为阴性而开始接受新的免疫抑制治疗。胶原血管病是最常见的基础疾病(62 名患者,54%)。无论患者是否为治疗胶原血管病而接受免疫抑制治疗,支气管镜检查都是有用的(P = 0.47)。经支气管活检与支气管镜检查的诊断率相关(54.7% vs 35.5%,P = 0.049)。其他临床因素,如放射学检查结果、呼吸衰竭或支气管镜检查时使用抗生素等,对诊断率没有显著影响。结论:我们的研究表明,经支气管活检可能是免疫功能低下的肺部浸润患者获得诊断的有效方法。此外,我们的数据还表明,支气管镜检查对于因治疗胶原血管病和其他潜在疾病而导致免疫力低下的患者也很有用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic yield of flexible bronchoscopy for immunocompromised patients with lung infiltrates: A single-center, retrospective study

Background

Pulmonary complications are associated with mortality in immunocompromised patients. The usefulness of bronchoscopy has been reported. However, clinical factors and procedures that influence diagnostic yield are still not established.

Materials and methods

We retrospectively analyzed 115 bronchoscopies performed on 108 immunocompromised patients, defined as those who take corticosteroids and/or immunosuppressants. We evaluated clinical factors, sampling procedures, final diagnosis, and severe complications of bronchoscopy.

Results

The clinical diagnosis was obtained in 51 patients (44%). Of those, 33 cases were diagnosed as infectious diseases and 18 as non-infectious diseases. Nine out of 115 cases (7.8%) initiated new immunosuppressive treatment for an underlying disorder based on the negative microbiological results obtained with bronchoscopy. Collagen vascular disease was the most common underlying disorders (62 patients, 54%). Bronchoscopy was useful regardless of whether the patient was immunosuppressed to treat collagen vascular disease (P = 0.47). Performing transbronchial biopsy correlated with better diagnostic yield of bronchoscopy (54.7% vs 35.5%, P = 0.049). Other clinical factors, such as radiological findings, respiratory failure or antibiotic use at the time of bronchoscopy did not significantly influence diagnostic yield. Respiratory failure requiring intubation after bronchoscopy occurred only in one case (0.9%).

Conclusions

Our study implied the transbronchial biopsy may be a useful procedure for reaching a diagnosis in immunocompromised patients with pulmonary infiltrates. In addition, our data suggest the usefulness of bronchoscopy for immunocompromised patients due to the treatment of collagen vascular disease as well as other underlying disorders.

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来源期刊
Respiratory investigation
Respiratory investigation RESPIRATORY SYSTEM-
CiteScore
4.90
自引率
6.50%
发文量
114
审稿时长
64 days
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