JOURNAL ARTICLE

[Retrospective analysis of the prognosis factors in patients with idiopathic pulmonary fibrosis]

Jian Zhang, Hui Huang, Zhi-wei Lu, Zuo-jun Xu
Chinese Journal of Tuberculosis and Respiratory Diseases 2011, 34 (3): 174-8
21569682

OBJECTIVE: To investigate the prognostic implications of clinical and physiological variables, and the cellular classification of bronchoalveolar lavage fluid (BALF) in patients with idiopathic pulmonary fibrosis (IPF). The effect of treatment with glucocorticoids with or without cytotoxic drugs was also evaluated.

METHODS: The significances of clinical, arterial blood gas analysis, pulmonary function test, lung high-resolution computed tomography, echocardiography and BALF in the prognosis of patients with IPF were assessed in 65 patients with IPF at diagnosis. Univariate Cox proportional-hazards regression analysis was used to evaluate the various parameters associated with hazard ratio. The survival rates of all groups were compared using the Kaplan-Meier method.

RESULTS: In 38 months of average follow-up time, the survival rate of the patients was 43.1%, and the median survival time was 39 months after diagnosis. Univariate Cox proportional-hazards regression analysis showed that body mass index, clubbing fingers, ESR, PaO(2)/FiO(2), SaO(2), TLC%, D(L)CO%, pulmonary arterial pressure and the percent of neutrophil in BALF were factors that affected the prognosis of the patients with IPF (HR 0.842 - 1.945, Wald 3.782 - 12.963, P < 0.05). In the meanwhile, the patients were divided into 2 groups by the median of significant variables in univariate Cox proportional-hazards regression analysis (the cut off point value), and the survival rate group comparison showed statistically significant difference in body mass index, clubbing fingers, ESR, TLC% as well as D(L)CO% (Log-rank 3.907 - 10.452, P < 0.05), while glucocorticoids with or without cytotoxic drugs for patients with IPF did not change the prognosis (Log-rank 2.405, P > 0.05).

CONCLUSIONS: Body mass index, clubbing fingers, ESR, PaO(2)/FiO(2), TLC%, and D(L)CO% maybe the factors affecting the prognosis of patients with IPF, while glucocorticoids with or without cytotoxic drugs did not change the course of IPF.

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