UNASSIGNED: Medical records were used to retrospectively investigate the prognosis and clinical information of 13 patients diagnosed with MTB complicated by ARDS among 68 patients diagnosed with MTB at our hospital between January 1994 and October 2016. None of the patients had multidrug resistant tuberculosis (TB). MTB was diagnosed by 1 radiologist and 2 respiratory physicians based on the observation of randomly distributed, uniformly sized diffuse bilateral nodules on chest computed tomography and the detection of mycobacterium TB from clinical specimens. ARDS was diagnosed based on the Berlin definition of ARDS. The effect of steroid pulse therapy on death within 3 months of hospitalization was examined using Cox proportional hazards models. Variables were selected by the stepwise method (variable reduction method).
UNASSIGNED: Six of 8 patients with MTB complicated by ARDS were alive 3 months after hospitalization in the steroid pulse therapy group, whereas only 1 of 5 patients was alive in the non-steroid pulse therapy group. Analysis of factors related to the survival of patients with MTB complicated by ARDS revealed that steroid pulse therapy was the strong prognostic factor (hazard ratio = 0.136 (95 % CI: 0.023-0.815)).
UNASSIGNED: Our findings suggest that steroid pulse therapy improves the short-term prognosis of patients with MTB complicated by ARDS.
UNASSIGNED:回顾性分析1994年1月至2016年10月我院收治的68例MTB患者中13例MTB并发ARDS患者的预后及临床资料。没有患者患有耐多药结核病(TB)。根据随机分布的观察,由1名放射科医生和2名呼吸内科医师诊断为MTB,胸部计算机断层扫描上大小均匀的弥漫性双侧结节,以及从临床标本中检测到结核分枝杆菌。根据柏林对ARDS的定义诊断ARDS。使用Cox比例风险模型检查了类固醇脉冲治疗对住院3个月内死亡的影响。通过逐步方法(变量缩减方法)选择变量。
UNASSIGNED:8例MTB并发ARDS患者中有6例在类固醇脉冲治疗组住院3个月后存活,而非类固醇脉冲治疗组5例患者中只有1例存活.对MTB并发ARDS患者生存相关因素的分析显示,激素冲击治疗是预后的重要因素(风险比=0.136(95%CI:0.023-0.815))。
UNASSIGNED:我们的研究结果表明,类固醇脉冲治疗可改善MTB并发ARDS患者的短期预后。