92例艾滋病患者死亡原因分析

Analysis of 92 dead acquired immune deficiency syndrome(AIDS)patients

目的了解艾滋病患者的死因结构,改善防治对策。方法对收治的92例艾滋病死亡病例进行回顾性分析。结果大部分死亡患者均未高效抗逆转录病毒治疗(HAART),总的机会性感染致死占88.1﹪(81/92)。已进行HAART的患者死因:非艾滋病相关的因素、药物副作用及感染。未进行HAART的患者94.2﹪(81/86)死于机会性感染。CD4+T淋巴细胞≥200个/μl时引起死亡的病原菌与非HIV感染者相似。CD4+T淋巴细胞<100个/μl的死亡原因是肺部感染、马尔尼菲青霉病(PSM)、结核病、耶氏肺孢子菌肺炎、感染性休克、隐球菌性脑膜炎等均是致死的重要原因。CD4+T淋巴细胞<50个/μl时因PSM死亡的占33.3%(16/48)。结论机会性感染仍是艾滋病患者主要的死亡原因,不同CD4+T淋巴细胞水平、不同的地域及是否HAART死因均有差异,适宜时机及时HAART可降低患者死亡率。

Objective To understand the composition of dead AIDS patients, and improve the prevention and treatment of AIDS. Methods The clinical data of 92 dead AIDS patients were analyzed. Results Most of patients did not receive the efficient antiretroviral therapy （ HAART ）.Opportunistic infection occurred to 88.1% （ 81/92 ） of the patients .The death causes of patients received HAART were not related to AIDS, drug side-effect and infection.The percentage of deaths cause of opportunistic infection was 94.2% （81/86） in the patients not received HAART. When the CD4＋T lymphocytes was ≥200/μl, the pathogenic bacterias leading to death in HIV-infection patients were similar to the patients without HIV-infection.When the CD4 ＋T lymphocytes was 〈100/μl,the primary dead causes were PSM, tuberculosis,PCP, septic shock, cryptococcal meningitis and so on.When the CD4＋T lymphocytes was〈50/μl, the percentage of the death cause of PSM was 33.3% （16/48）. Conclusion The primary cause of death was opportunistic infection in the HIV-infeeted patients. The causes of death with different levels of CD4＋T lymphocytes, different regional and whether received HAART were different. The appropriate and timely HAART could reduce the death rate of the patients.