艾滋病患者合并机会性感染的临床特点及预后分析

赵华; 张利; 李洪云; 陈静; 梁冬梅; 赵鹏

doi:10.3969/j.issn.2095-5227.2021.01.010

艾滋病患者合并机会性感染的临床特点及预后分析

Opportunistic infection in AIDS patients: Clinical features, prognosis and its risk factors

摘要

摘要:
背景目前我国人类免疫缺陷病毒感染人数已达100万以上。因艾滋病(acquired immunodeficiency syndrome，AIDS)死亡人数高居所有传染病死亡人数之首，其致死主要原因为艾滋病相关的机会性感染。
目的分析AIDS合并机会性感染患者的临床特点，探讨引起机会性感染的易感因素及机会性感染患者死亡的危险因素。
方法回顾性分析解放军总医院第五医学中心2011 - 2018年收治的398例AIDS患者的临床资料，其中174例合并机会性感染患者。
结果 AIDS合并机会性感染患者最主要的3个临床表现为发热(82.18%)、咳嗽(62.07%)、乏力(45.98%)，同时机会性感染发生的部位以呼吸道感染最为常见(73.56%)。174例合并机会性感染患者中死亡35例，病死率20.11%，入院时基线CD4⁺ T淋巴细胞数量＜200/μL(OR=4.365，95% CI：1.045 ~ 18.232)及未行高效抗逆转录病毒治疗(OR=4.777，95% CI：1.072 ~ 21.291)是患者死亡的独立影响因素。
结论 AIDS患者CD4⁺ T淋巴细胞数量越少，发生机会性感染的概率越高；入院时CD4⁺T淋巴细胞数量、是否已启动高效抗逆转录病毒治疗与患者预后密切相关。

Abstract:
Background Nowadays, more than one million people are infected with HIV in China. The mortality of AIDS is the highest in all the infectious diseases, and opportunistic infection is the main cause.
Objective To study the clinical characteristics and predisposing factors of opportunistic infections and risk factors of death in AIDS patients.
Methods A retrospective analysis of 398AIDS patients who were admitted into the Fifth Medical Center of Chinese PLA General Hospital from 2011 to 2018 was performed, and 174 of them were complicated with opportunistic infections.
Results The top three clinical manifestations of AIDS patients with opportunistic infection were fever (82.18%), cough (62.07%), and weakness (45.98%). The respiratory system was most often involved with opportunistic infections (73.56%).Among 174 patients with opportunistic infection, 35 died, with a mortality rate of 20.11%. The patients with CD4⁺ T cells count less than 200/μL and those who did not take highly active antiretroviral treatment(HAART) had higher mortality.
Conclusion AIDS patients with lower CD4⁺ T cells have higher probability of opportunistic infection. CD4⁺ T cells counts and HAART are closely related to the prognosis of patients.

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