Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China
单位：[1]Department of Respiratory and Critical Care Medicine, Clinical Microbiologyand Infectious Disease Lab, China-Japan Friendship Hospital, Beijing 100029,China[2]Department of Respiratory and Critical Care Medicine, The FirstAffiliated Hospital of Wenzhou Medical University, Wenzhou, China[3]Department of Respiratory Medicine, Peking Union Medical CollegeHospital, Chinese Academy of Medical Sciences and Peking Union MedicalCollege, Beijing, China[4]Department of Respiratory Medicine, Shanghai EastHospital, Tongji University School of Medicine, Shanghai, China[5]Institute ofRespiratory Disease, The First Affiliated Hospital of China Medical University,Shenyang, China[6]Department of Institute of Clinical Medical Sciences,China-Japan Friendship Hospital, Beijing, China[7]The department ofradiology, China-Japan Friendship Hospital, Beijing, China[8]TsinghuaUniversity School of Medicine, Beijing, China[9]Department of RespiratoryMedicine, The First Affiliated Hospital of Guangxi Medical University,Nanning, China[10]Department of Respiratory and Critical Care Medicine,Changhai Hospital, the Second Military Medical University, Shanghai, China[11]Department of Respiratory and Critical Care Medicine, Key Laboratory ofPulmonary Diseases of Health Ministry, Tongji Hospital, Tongji MedicalCollege, Huazhong University of Science and Technology, Wuhan, China华中科技大学同济医学院附属同济医院[12]Department of Respiratory and Critical Care Medicine, Fuzhou GeneralHospital of Fujian Medical University, Fuzhou, China[13]Department ofRespiratory and Critical Care Medicine, Fujian Provincial Hospital, ProvincialClinical Medical College, Fujian Medical University, Fuzhou, China[14]Department of Respiratory and Critical Care Medicine, Guizhou ProvincialPeople’s Hospital, Guiyang, Guizhou Province, China[15]Department ofPulmonary and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-senUniversity, Institute of Respiratory Diseases of Sun Yat-Sen University,Guangzhou, China中山大学附属第三医院[16]Department of Respiratory and Critical Care Medicine,Shanghai Pulmonary Hospital, Tongji University School of Medicine,Shanghai, China[17]Department of Respiratory Medicine, The Second XiangyaHospital, Central-South University, Changsha, China[18]Department of Respiratory and Critical Care Medicine, Ruijin Hospital, School of Medicine,Shanghai Jiaotong University, Shanghai 200025, China
Background The European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria are widely used in the diagnosis of invasive pulmonary aspergillosis (IPA), but they only apply to immunocompromised patients. We here aimed to identify clinical characteristics helpful to the diagnosis of IPA in non-immunocompromised patients. Methods This is a multicenter retrospective study. Data were collected from adult patients with IPA admitted to 15tertiary hospitals in Chinafrom 2010 to 2016. Results We included 254 patients in the study, of whom 66 (26.0%) were immunocompromised, and 188 (74.0%) were not. Airway-invasion-associated computed tomography (CT) signs including patchy exudation along the airway (67.6% vs. 45.5%,P = 0.001) and thickened airway wall (42.0% vs. 16.7%,P < 0.001) were more common in non-immunocompromised patients than in immunocompromised ones, and angio-invasive CT signs were more common in immunocompromised patients (55.3% vs.72.7%,P = 0.013). Typical angio-invasive CT signs were delayed in non-immunocompromised IPA patients, whereas airway-invasive signs appear earlier. Host immunocompromised condition was associated with ICU admission and/or intubation (OR 1.095; 95% CI 1.461-6.122;P = 0.003). Poor prognosis (35.5% vs. 21.1%,P = 0.005) was more common in immunocompromised patients. Conclusion Airway-invasion-associated CT presentations at early stages of the disease are characteristic of IPA in non-immunocompromised hosts.
基金：
National Key R&D Program of China [2017 YFC 13097004]; Shanghai Key Discipline for Respiratory Diseases [2017ZZ02014]; innovative research team of high-level local universities in Shanghai
第一作者单位：[1]Department of Respiratory and Critical Care Medicine, Clinical Microbiologyand Infectious Disease Lab, China-Japan Friendship Hospital, Beijing 100029,China
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推荐引用方式(GB/T 7714)：
Zhibo Liu,Yuping Li,Xinlun Tian,et al.Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China[J].RESPIRATORY RESEARCH.2020,21(1):doi:10.1186/s12931-020-01424-x.
APA：
Zhibo Liu,Yuping Li,Xinlun Tian,Qinghua Liu,Erran Li...&Bin Cao.(2020).Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China.RESPIRATORY RESEARCH,21,(1)
MLA：
Zhibo Liu,et al."Airway-invasion-associated pulmonary computed tomography presentations characteristic of invasive pulmonary Aspergillosis in non-immunocompromised adults: a National Multicenter Retrospective Survey in China".RESPIRATORY RESEARCH 21..1(2020)
