The Analysis Of Clinical Characteristics And Prognostic Risk Factors Of Severe Pneumonia In Non-HIV Immunosuppressed Patients

Objective:To analyze the clinical characteristics and prognostic risk factors of severe pneumonia in non-HIV immunosuppressed patients,to provide reference for clinical diagnosis and treatment.Methods:101 cases of non-HIV immunosuppressed patients with severe pneumonia in the intensive care unit of the respiratory second department,Second Hospital of Hebei Medical University were admitted.The patients were divided into the survival group and the death group according to the transfer after admission to hospital in 28 days.We compared and analysed the two groups of patients'admission general information and clinical data,and analysis the risk factors.Results:1 There was no significant difference in gender,age,body mass index,length of hospital stay,clinical symptoms,number of positive fluids within 72hours,cytology classification in alveolar lavage fluid,basic disease,the treatment of hormones and/or immunosuppressive agents?P<0.05?.2 The imaging manifestations were mainly infiltrates of both lungs,with more lesions involving the stroma,and mortality was higher in patients with pneumothorax and mediastinal emphysema in the death group?P<0.05?.3 Both groups of patients had a wide spectrum of pathogens.The infection of multiple drug-resistant bacteria and opportunistic pathogens were high.There were more patients with multidrug resistant bacterial infection in the death group than in the survivors group?P<0.05?.4 The patients'condition was severe.The APACHE II score,hsCRP,NEUT%were higher in the death group?P<0.05?.LY,absolute cell counts and percentages of CD³⁺and CD⁴⁺were lower?P<0.05?,and the proportion of patients with invasive mechanical ventilation was higher in the death group?P<0.05?.Conclusion:1 APACHE II score,hsCRP,and NEUT%were higher in the death group.LY,absolute cell counts and percentages of CD³⁺and CD⁴⁺were lower in the death group.The number of bacterial infections and lung stalls caused by ventilators were higher,and the mechanical ventilation rate was higher in the death group.2 Logistic regression analysis showed that the need for invasive mechanical ventilation and ventilator-induced lung injury were independent risk factors for the prognosis of severe pneumonia in non-HIV immunosuppressed patients.