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...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；展开更多
Objective To investigate the changes of subgroups of peripheral blood T lymphocytes in patients with severe acute respiratory syndrome (SARS) and its clinical significance.Methods Subgroups of blood T lymphocytes in 9...Objective To investigate the changes of subgroups of peripheral blood T lymphocytes in patients with severe acute respiratory syndrome (SARS) and its clinical significance.Methods Subgroups of blood T lymphocytes in 93 patients with SARS were detected by flow cytometer. The results detected in 64 normal subjects and 50 patients with AIDS served as controls.Results The numbers of CD3 +, CD4 +, and CD8 + lymphocytes all significantly decreased in acute phase of patients with SARS [(722±533)/μl, (438 ±353)/μl, (307±217)/μl)] compared with those in normal controls [ (1527±470)/μl, (787±257)/μl, (633±280)/μl, all P<0. 01) ], which was different from what we observed in patients with AIDS who had decreased CD4 + [ (296±298)/μl] but increased CD8 + [ (818 ±566)/μl counts. The counts of CD3+, CD4+, and CD8 + lymphocytes decreased more apparently in patients with severe SARS. All the five patients who died had CD4 + counts less than 200/μl. As the patients' condition improved, CD3 +, CD4 +, and CD8 + counts gradually returned to normal ranges.Conclusion The damage of cellular immunity is probably an important mechanism of pathogenesis of SARS.展开更多
文摘目的探讨影响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；
文摘Objective To investigate the changes of subgroups of peripheral blood T lymphocytes in patients with severe acute respiratory syndrome (SARS) and its clinical significance.Methods Subgroups of blood T lymphocytes in 93 patients with SARS were detected by flow cytometer. The results detected in 64 normal subjects and 50 patients with AIDS served as controls.Results The numbers of CD3 +, CD4 +, and CD8 + lymphocytes all significantly decreased in acute phase of patients with SARS [(722±533)/μl, (438 ±353)/μl, (307±217)/μl)] compared with those in normal controls [ (1527±470)/μl, (787±257)/μl, (633±280)/μl, all P<0. 01) ], which was different from what we observed in patients with AIDS who had decreased CD4 + [ (296±298)/μl] but increased CD8 + [ (818 ±566)/μl counts. The counts of CD3+, CD4+, and CD8 + lymphocytes decreased more apparently in patients with severe SARS. All the five patients who died had CD4 + counts less than 200/μl. As the patients' condition improved, CD3 +, CD4 +, and CD8 + counts gradually returned to normal ranges.Conclusion The damage of cellular immunity is probably an important mechanism of pathogenesis of SARS.
