摘要
目的探讨影响AIDS合并马尔尼菲青霉菌病（PSM）预后的因素。方法165例经病嗯学确诊的AIDS合并PSM患者，根据预岳分成牛存组和死亡组。应用Logistic回归，分析2j个可能影响疾病预后的临床和实验室指标．筛选出独立预后因素。结果AIDS合并PSM患者中。生有组121例，死亡组44例，病死率为26．7％。单因素分析显示．影响AIDS合并PSM预后的因素包括皮疹、细菌和（或）其他真菌性肺炎、CMV感染、败血症、肾功能损伤、PLT减少、Hb、CD4-T淋巴细胞计数、Alb、伊曲康唑（ITR）广子贯疗法及高效抗反转录病毒治疗（HAART）。多因素分析显示，去除各因素之间相互混杂的影响，筛选出细菌或其他真菌性甘市炎（OR=6．539；95％CI2．312，18．498）、败血症（OR=15．307；95%,CI1．473．42．462）及PLT减少（OR=7．763：95％CI2．658，22．675）是AIDS合并PSM死亡的危险因素，而ITR序贯疗法（OR=0．088；95％CI 0．013．0．611）与HAART（OR=0．084；95% CI 0．026，0．269）是其保护性因素。结论合并细菌或其他真菌性肺炎、败血症与PLT减少是AIDS合并PSM预后不良的危险因素，ITR序贯疗法和HAART则可减少死亡风险，改善预后；
Objective To explore the prognostic factors of Penicilliosis Marneffei （PSM）in acquired immunodeficiency syndrome （AIDS） patients. Methods One hundred and sixty five cases of AIDS complicated with PSM were divided into survival group and death group, and were studied retrospectively. Twenty five potential variables from clinical and biochemical examinations were evaluated by Logistic regression analysis in order to determine independent prognostic factors. Results There were 121 cases in the survival group and 44 cases in the death group, witha mortality rate of 26. 7%. In the univariate analysis, variables that were significantly associated with the prognosis of PSM included rash, bacterial/fungal pneumonia（except Penicillium marneffei pneumonia and Pneumaocystis pneumonia）, cytomegalovirus （CMV） infection, sepsis, impaired renal funetion, thrombocytopenia, the hemoglobin （Hb） level in peripheral blood, CD4- lymphocyte count, the serum albumin level, itraconazole sequential therapy and highly active antiretroviral therapy （HAART）. Multivariate Logistic regression analysis showed variables including bacterial/fungal pneumonia （OR=6. 539= 95%CI 2. 312, 18. 498）, sepsis （OR=15. 307; 95%CI 1. 473, 42. 462） and thrombocytopenia （OR 7. 763; 95%CI 2. 658, 22. 675） were risk factors related to the mortality of AIDS patients with PSM, meanwhile,itraeonazole sequential therapy （OR 0. 088; 95% CI 0. 013, 0.611 ） and HAART （OR = 0. 084 ; 95% CI0. 026, 0. 269） provided protective effect. Conclusions Bacterial/fungal pneumonia, sepsis, and thrombocytopenia are the primary risk factors contributing to the poor prognosis of AIDS patients with PSM, while itraconazole sequential therapy or HAART can reduce the mortality and improve the prognosis.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2009年第11期664-667,共4页
Chinese Journal of Infectious Diseases
基金
广州市重大科技攻关资助项目（200621E0091）
广州市医药卫生科技重点资助项目（2005-Zdi-04）
关键词
获得性免疫缺陷综合征
青霉属
真菌病
回归分析
预后
Acquired immunodeficiency syndrome
Penicillium
Mycoses
Regression analysis
Prognosis
