摘要
目的评价手术治疗非小细胞肺癌(NSCLC)合并人类免疫缺陷病毒(HIV)阳性患者的临床效果。方法回顾性分析收集1998年9月至2006年4月莫桑比克马普托中心医院胸外科手术治疗的NSCLC合并HIV阳性患者29例(HIV阳性组),并选择同期34例HIV检测呈阴性NSCLC患者作为对照组(HIV阴性组)。分析两组患者的手术时间、术中出血量、术后引流量、手术后胸腔引流量、手术后肺部和伤口感染率、手术后住院日、HIV阳性组CD4计数,并随访生存时间等临床指标。结果两组患者手术在死亡率上的差异没有统计学意义;HIV阳性组手术后肺部感染发生率比HIV阴性组高(31.03%vs5.88%,P=0.009),前者发生手术后肺部感染的危险比后者增加7倍以上(OR=7.200;95%可信区间(1.409,36.779));HIV阳性患者不同CD4计数手术后肺部感染发生率的差异有统计学意义(P=0.040),CD4计数与手术后肺部感染发生率呈负相关(r=-0.501;P=0.014);HIV阳性组与HIV阴性组患者在生存时间上差异无统计学意义(P=0.248)。结论 NSCLC合并HIV阳性患者手术后并发肺部感染危险增加且与患者CD4细胞计数呈负相关,但不会增加手术死亡率;伴随高效抗逆转录病毒治疗(HAART)的实行,其手术后生存期与HIV阴性者相似。对于非艾滋病发作期的该类患者,均应考虑积极地治疗。
Objective To evaluate the clinic outcomes of the surgical treatment of non-small cell lung cancer（NSCLC）in the patients infected with HIV.Methods 29 HIV-positive patients with NSCLC（HIV-positive group）were underwent thoracic surgery during Sept.1998 to Apr.2006 in the Central Hospital of Maputo,Mozambique.The clinical symptoms,such as operative time,operative blood loss,postoperative drainage quantity,the incidence of operative pulmonary and wound infection,operative mortality,CD4 counts,and survival time etc.were retrospectively analyzed to evaluate the clinical outcomes.The other 34 patients of NSCLC without HIV-infection,whom were received thoracic surgery during the same period,were made up as the control（HIV-negative group）.Results The operative mortality between the two groups was of no difference;the incidence of operative pulmonary infection of HIV-positive group was much higher than that of HIV-negative one（31.03% vs 5.88%,P =0.009）;the incidence of operative pulmonary infection was significantly different among different CD4 counts in HIV-infected patients,and this had negative correlation with CD4 counts（r=-0.501;P=0.014）;the survival time of the two groups was no difference.Conclusion NSCLC in HIV infected patients who were received thoracic surgery had higher incidence of operative pulmonary infection,but no more significant difference in operative mortality than that of HIV-negative ones;in the era of HAART,the survival of NSCLC in HIV-infected patients was as same as the HIV negative ones.
出处
《检验医学与临床》
CAS
2010年第18期1958-1960,共3页
Laboratory Medicine and Clinic
