Chest:特发性肺纤维化急性加重对肺移植结局的影响

2018-07-04 xiangting MedSci原创

与在IPF稳定期间移植的患者相比,AE-IPF期间移植的IPF患者的长、短期生存率更差。

特发性肺纤维化急性加重(AE-IPF)的预期中位生存期为3个月。肺移植是AE-IPF的潜在救命疗法。然而,目前关于AE-IPF期间移植结局的知识仅限于少量小型回顾性研究,且仅报告了移植后一年的生存率。

研究人群包括2012年至2016年期间在单个机构进行肺移植的IPF患者。研究人员收集肺分配评分(LAS)、住院和生存数据。主要结局是IPF稳定期间移植患者vs.AE-IPF期间移植患者的生存率。

在89例需要肺移植的IPF患者中,52例在IPF稳定期间移植,37例因AE-IPF住院。在这37例患者中,9例在移植前死亡,28例在AE-IPF期间移植。在AE-IPF期间移植的患者中有50%在平均随访1.6±1.2年期间死亡,而IPF稳定期间移植的患者中有12%在平均随访2.6±1.2年间死亡。IPF稳定期间移植患者在移植后1年和3年的Kaplan-Meier生存曲线分别为94%和90%,而在AE-IPF期间移植患者为71%和60%(p=0.0001)。LAS高于80 vs. LAS低于80的3年死亡风险比为5.7(95%CI 2.33-14.0,p<0.0005)。

与在IPF稳定期间移植的患者相比,AE-IPF期间移植的IPF患者的长短期生存率更差。伴AE-IPF和高LAS的患者可能无法得到预期的肺移植生存优势。

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    2019-05-24 Smile2680
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