摘要
目的探讨免疫学指标检测对人免疫缺陷病毒（HIV）感染者腹部手术后脓毒症发生的预测作用。方法回顾性分析2009年1月至2010年12月间在复旦大学附属公共卫生临床中心行腹部手术的34例术前未合并脓毒症的HIV感染者的临床资料。结果34例HIV感染患者中男31例，女3例，年龄（45±13）岁。术后新发脓毒症19例，其术前CD4水平、术后CD4水平、术前CD4／CD8、术后血小板水平均显著低于15例无脓毒症患者（均P〈0．05）。术前CD4细胞计数小于或等于200×10^6／L的患者19例，其术后脓毒症发生率84．2％（16／19）：术前CD4细胞计数大于200×10^6／L的患者15例，其术后脓毒症发生率为20．0％（3／15），差异有统计学意义（P〈0．05）。34例患者中围手术期死亡3例．均死于脓毒性休克和多器官功能衰竭。结论CD4细胞计数可作为预测HIV感染患者腹部术后脓毒症发生的一个参考指标。
Objective To study postoperative sepsis in HIV/AIDS patients who underwent abdominal operations. Methods A retrospective analysis was performed to study 34 HIV/AIDS patients treated between January 2009 and December 2010 at the Shanghai Public Health Clinical Center Affiliated to Fudan University. Results There were 31 males and 3 females in this cohort with a mean age of 45±13 years. Nineteen patients developed postoperative sepsis. The levels of preoperative CD4, postoperative CD4, preoperative CD4/CD8, and postoperative platelet were significantly lower than those without sepsis （all P〈0.05）. Among 19 patients with a preoperative CD4 cell count less than or equal to 200×10^6/L, the incidence of postoperative sepsis rate was 84.2%（16/19）, and for those with a preoperative CD4 cell count greater than 200×10^6/L, the incidence of postoperative sepsis rate was 20.0%（3/15）, the difference was statistically significant（P〈0.05）. There were 3 postoperative deaths. Conclusion CD4 cell count can be used as a predictive marker for the development of postoperative sepsis in patients with HIV/AIDS.
出处
《中华胃肠外科杂志》
CAS
北大核心
2011年第7期500-502,共3页
Chinese Journal of Gastrointestinal Surgery
基金
上海市公共卫生临床中心课题（KSF0222）
关键词
人类免疫缺陷病毒
腹部手术
脓毒症
CD4淋巴细胞计数
Human immunodeficiency viruses
Surgical procedures, abdominal
Sepsis
CD4 lymphocyte count
