Analysis Of Clinical Features And Related Risks Of Prognosis In Patients With Cytomegalovirus Pneumonia

Objective:To analyze the clinical characteristics of patients with cytomegalovirus pneumonia,and to analyze the risk factors related to death,so as to provide reference for clinical diagnosis and treatment.Methods:A retrospective case analysis study was used.The clinical data of 68 patients with cytomegalovirus pneumonia admitted to the Department of Respiratory Medicine of the Second Hospital of Hebei Medical University were collected.According to the patient's post-hospital outcome,the patients were divided into the survival group and the death group,and the severe pneumonia group and the non-severe pneumonia group.The general conditions and clinical data of the two groups of patients were compared and analyzed,and risk factors were analyzed.Results:1.The proportion of male patients in 68 patients(61.76%)was significantly higher than that in female patients(38.24%);The average age of68 patients was higher(60.22±15.92);The top three underlying diseases are kidney disease(33.82%),rheumatic disease(27.94%),and blood system disease(20.59%),accounting for more than 80%.2.More than 70%of the 68 patients had bacterial,fungal,or other atypical pathogen infections,and some patients even had a bloodstream infection with urinary tract infections.3.The patient's condition progressed rapidly.Nearly 70%of the patients were admitted to the ICU due to serious illness or progress at the time of admission.The proportion of patients requiring mechanical ventilation was higher(66.18%),and the average hospital stay was more than 14 days.4.There were no significant differences in gender,age,clinical symptoms,number of positive fluid balances within 72 hours,imaging findings,underlying diseases,types of immunosuppressive drugs,and time of immuno-suppressive application in the death group and the survival group(P<0.05).5.The proportion of hormones and immunosuppressive agents in the death group was higher than that in the survival group,and there was a statistically significant difference(P<0.05).In the death group,the application of hormone time(greater than 3 months)was significantly different from the survival group(P<0.05),the number of application of immunosuppressive agents in the death group,the application time(more than 3 months)and the proportion of patients were higher than the survival group,but there was no significant difference(P>0.05).The analysis may be related to the number of samples collected.6.Oxygenation index and serum albumin content were lower in the two groups at admission,and the death group was significantly lower than the survival group,there was significant difference(P<0.05).7.In addition to infection with cytomegalovirus,the two groups of patients were also infected with multiple infections of bacteria,fungi and other pathogens.The proportion of death combination and other pathogen infections was significantly higher than that of the survival group,and the death group was infected with cocci and patients with bloodstream infections.There was a significant difference in the survival group(P<0.05).8.The hsCRP and neutrophil percentage in the death group were higher than those in the survival group(P<0.05),and the absolute counts and percentages of LY,CD3~+,CD4~+were lower(P<0.05),and CD8~+accounted for The percentage of lymphocytes was higher and CD4~+/CD8~+was lower,but there was no statistical difference.9.The proportion of patients requiring non-invasive/invasive mechanical ventilation in the death group was higher(P<0.05).Conclusion:1.Among immunosuppressed patients,males are more likely to be infected with CMV than females;and The average age of patients infected with CMV is higher.Patients infected with CMV are mainly patients with kidney disease,rheumatic diseases,basic diseases of blood system diseases and receiving glucocorticoids or immunosuppressive agents.2.The death group hsCRP,WBC count(except those with hematological systemic diseases),NEUT%higher,death group LY,CD3~+,CD4~+T lymphocyte count and percentage were lower(P<0.05),CD8+accounted for a higher percentage of lymphocytes and lower CD4~+/CD8~+.3.The proportion of death combined with other pathogens such as bacteria,development of severe pneumonia,admission to the ICU,presence of respiratory failure,and ultimately non-invasive/invasive mechanical ventila-tion were higher than in the survival group.4.Multivariate logistic regression analysis showed that oxygenation index and serum albumin level were independent risk factors for the prognosis of patients with cytomegalovirus pneumonia.