基于临床及胸部影像资料分析血液系统恶性肿瘤合并肺毛霉菌病患者预后影响因素

doi:10.19871/j.cnki.xfcrbzz.2025.06.012

新发传染病电子杂志 ›› 2025, Vol. 10 ›› Issue (6): 75-80.doi: 10.19871/j.cnki.xfcrbzz.2025.06.012

基于临床及胸部影像资料分析血液系统恶性肿瘤合并肺毛霉菌病患者预后影响因素

朱梦莹¹, 李红美², 李子薇¹, 赵云舒¹, 韩舒婷¹, 陆紫微¹, 王欣¹, 李勇刚¹

1.苏州大学附属第一医院放射科,江苏苏州 215000;
2.苏州大学苏州医学院,江苏苏州 215000

收稿日期:2025-08-11 出版日期:2025-12-31 发布日期:2026-01-26
通讯作者: 李勇刚,Email：Liyonggang@suda.edu.cn
基金资助:
1.江苏省卫生健康委员会重点科研项目（K2023027）; 2.江苏省研究型医院学会感染与炎症放射学专业委员会科研基金（GY202301）

Prognosis analysis of hematological malignancies complicated by pulmonary mucormycosis based on clinical and chest imaging data

Zhu Mengying¹, Li Hongmei², Li Ziwei¹, Zhao Yunshu¹, Han Shuting¹, Lu Ziwei¹, Wang Xin¹, Li Yonggang¹

1. Department of Radiology ,The First Affiliated Hospital of Soochow University, Jiangsu Suzhou 215000, China;
2. Suzhou Medical College, Soochow University, Jiangsu Suzhou 215000, China

Received:2025-08-11 Online:2025-12-31 Published:2026-01-26

摘要/Abstract

摘要： 目的总结血液系统恶性肿瘤合并肺毛霉菌病患者的临床资料、实验室检查及胸部影像资料,分析影响患者预后的相关因素。方法选取2017年1月至2023年6月苏州大学附属第一医院收治的46例血液系统恶性肿瘤合并肺毛霉菌病患者,根据临床结局将患者分为生存组（20例）和死亡组（26例）,收集患者的临床资料、实验室检查及胸部影像资料,采用Kaplan-Meier生存分析探索影响预后的因素,多因素Cox回归分析评估与患者死亡风险相关的因素。结果 Kaplan-Meier生存分析表明,患者原发病骨髓象未缓解（χ²=7.872,P=0.005）、初次诊断毛霉菌病时粒细胞缺乏（χ²=5.160,P=0.023）、肾功能不全（χ²=5.818,P=0.016）、咯血（χ²=4.080,P=0.043）、胸腔积液（χ²=8.718,P=0.003）与患者预后不良相关（P<0.05）。多因素Cox回归分析证实,原发病骨髓象未缓解（HR=3.798,95%CI：1.123~12.843）、胸腔积液（HR=3.176,95%CI：1.180~8.549）是预后不良的独立危险因素（P<0.05）。该多因素Cox回归模型的一致性指数为0.738,提示模型具有中等程度的预后预测效能。结论原发病控制不佳将显著增加血液系统恶性肿瘤合并肺毛霉菌病患者死亡风险,需强化对原发病的综合管理。

关键词: 血液系统恶性肿瘤, 肺毛霉菌病, 计算机断层成像, 胸腔积液, 预后因素

Abstract: Objective To assess the clinical, laboratory, and chest CT data and identify prognostic factors in patients with hematological malignancies complicated by pulmonary mucormycosis. Method We retrospectively collected clinical, laboratory and chest imaging data from patients with hematological malignancies complicated by pulmonary mucormycosis who were admitted to the First Affiliated Hospital of Soochow University from January 2017 to June 2023. Patients were divided into a survival group (n=20) and a death group (n=26) and their clinical profiles, laboratory findings, and chest imaging characteristics were compared. The Kaplan-Meier survival analysis was used to identify the univariate factors affecting prognosis. Cox regression analysis was employed to evaluate factors associated with the risk of death. Result Kaplan-Meier analysis revealed that an unrelieved state of the bone marrow status of the primary disease (χ²=7.872, P=0.005), granulocytopenia at the initial diagnosis of mucormycosis infection (χ²= 5.160, P=0.023), renal insufficiency (χ²=5.818, P=0.016), hemoptysis (χ²=4.080, P=0.043), and pleural effusion (χ²=8.718, P=0.003) were associated with poor prognosis (P<0.05). Multivariate Cox regression analysis confirmed that non-remission of the primary disease bone marrow (OR=3.798, 95%CI 1.123-12.843) and pleural effusion (OR=3.176, 95%CI 1.180-8.549) were independent risk factors for poor prognosis (P<0.05), are independent risk factors for poor prognosis. The concordance index of this multivariate Cox regression model is 0.738, which indicates that the model has a moderate prognostic predictive performance. Conclusion Inadequate control of the primary hematological malignancy significantly increases mortality risk. Intensive management of the underlying hematological disease is critical for improving prognosis.

Key words: Hematological malignancies, Pulmonary mucormycosis, Computed tomography, Pleural effusion, Prognostic factors

中图分类号:

R563
R725.1

朱梦莹, 李红美, 李子薇, 赵云舒, 韩舒婷, 陆紫微, 王欣, 李勇刚. 基于临床及胸部影像资料分析血液系统恶性肿瘤合并肺毛霉菌病患者预后影响因素[J]. 新发传染病电子杂志, 2025, 10(6): 75-80.

Zhu Mengying, Li Hongmei, Li Ziwei, Zhao Yunshu, Han Shuting, Lu Ziwei, Wang Xin, Li Yonggang. Prognosis analysis of hematological malignancies complicated by pulmonary mucormycosis based on clinical and chest imaging data[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(6): 75-80.

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基于临床及胸部影像资料分析血液系统恶性肿瘤合并肺毛霉菌病患者预后影响因素

Prognosis analysis of hematological malignancies complicated by pulmonary mucormycosis based on clinical and chest imaging data

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