摘要
目的分析艾滋病(AIDS)患者合并真菌感染的危险因素及细胞因子的水平变化。方法选取2017年1月-2019年5月保定市传染病医院收治的AIDS患者252例为研究对象,回顾性分析患者临床资料及检出真菌情况,单因素及多因素Logistic回归分析AIDS患者真菌感染的危险因素,分析真菌感染患者炎症因子白细胞介素-10(Interleukin-10,IL-10)、白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子(Tumor necrosis factor-α,TNF-α)水平变化。结果252例AIDS患者中合并真菌感染共100例,共检出真菌123株。单因素分析结果,侵入性操作、是否系统抗病毒治疗、抗菌药物使用时间、外周血CD4^+计数、血清白蛋白浓度为AIDS患者发生真菌感染的危险因素(P<0.05)。多因素Logistic回归分析,外周血CD4^+计数、系统抗病毒治疗、抗菌药物使用时间是AIDS患者发生真菌感染的独立危险因素(P<0.05)。AIDS合并真菌感染患者IL-10、IL-6、TNF-α水平均高于未合并真菌感染患者(P<0.05)。结论外周血CD4^+计数、系统抗病毒治疗、抗菌药物使用时间是影响AIDS患者发生真菌感染的独立危险因素,且AIDS合并真菌感染患者炎症因子升高。避免AIDS患者合并真菌感染除了要尽早发现诊断治疗外,还要提高患者的免疫功能,降低机会性感染。
OBJECTIVE To investigate the risk factors for fungal infection in AIDS patients and analyze the changes of cytokines.METHODS Totally 252 patients with AIDS who were treated in Baoding Infectious Diseases Hospital from Jan 2017 to May 2019 were recruited as the study objects,the clinical data of the patients and isolation rate of fungi were retrospectively analyzed,univariate analysis and multivariate logistic regression analysis were performed for the risk factors for fungal infection in the AIDS patients,and the changes of levels of inflammatory factors interleukin-10(IL-10),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)of the patients with fungal infection were observed.RESULTS Of the 252 AIDS patients,100 were complicated with fungal infection,and totally 123 strains of fungi were isolated.Univariate analysis showed that the invasive operation,systemic antiviral treatment,time of use of antibiotics,peripheral blood CD4^+counts and serum albumin concentration were the risk factors for the fungal infection(P<0.05).Multivariate logistic regression analysis indicated that the peripheral blood CD4^+counts,systemic antiviral treatment and time of use of antibiotics were the independent risk factors for the fungal infection in the AIDS patients(P<0.05).The levels of IL-10,IL-6 and TNF-αof the AIDS patients complicated with fungal infection were significantly higher than those of the patients without fungal infection(P<0.05).CONCLUSION The peripheral blood CD4^+counts,systemic antiviral therapy and time of use of antibiotics are the independent risk factors for the fungal infection in the AIDS patients,and the levels of inflammatory factors of the AIDS patients complicated with fungal infection are elevated.In addition to the early detection,diagnosis and treatment,it is necessary to boost the immune function of the patients and reduce the incidence of opportunistic infection.
作者
石鹏辉
刘书兰
孙文龙
安伟娜
李永勤
范伟光
SHI Peng-hui;LIU Shu-lan;SUN Wen-long;AN Wei-na;LI Yong-qin;FAN Wei-guang(Baoding Infectious Diseases Hospital,Baoding,Hebei 071000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第9期1331-1334,共4页
Chinese Journal of Nosocomiology
基金
河北省科研基金资助项目(2016WD169)。
关键词
艾滋病患者
真菌
感染
炎症因子
AIDS patient
Fungus
Infection
Inflammatory factor
