C-反应蛋白水平与HIV/AIDS患者抗病毒治疗预后关系的研究

Relationship between C-reactive protein level and prognosis of HIV/AIDS patients after antiretroviral therapy

目的探讨C-反应蛋白(CRP)水平与人类免疫缺陷病毒/艾滋病(HIV/AIDS)抗病毒治疗3个月预后不良的关系,为临床判断抗病毒治疗早期预后提供依据。方法对152例HIV/AIDS患者抗病毒治疗后随访3个月,按预后分为预后不良组和非预后不良组,比较两组的CRP水平;按CRP水平分成CRP升高组及CRP正常组,比较两组预后不良发生率;采用多元logistic回归分析影响预后不良的危险因素。结果预后不良组CRP为6.59(0.12~36.12)mg/L,非预后不良组CRP为0.90(0.00~5.90)mg/L,两组差异有统计学意义(P<0.05);CRP正常组预后不良17例占14.4%,CRP升高组预后不良15例占44.1%,差异有统计学意义(P<0.05);多因素logistic回归分析显示,基线CRP越高,预后不良的危险度越高(OR=1.025,95%CI:1.006~1.044)。结论CRP升高的HIV/AIDS易出现预后不良,CRP水平是抗病毒治疗HIV/AIDS 3个月预后不良的独立危险因素。

OBJECTIVE To study the relationship between （;-reactive protem（UN-e） and severe AIDS-relatecl diseases or death （poor prognosis） in patients with HIV/AIDS in the first three months after antiretroviral therapy （ART） so as to provide a basis for clinical judgment of early prognosis after ART. METHODS A follow-up of 152 patients with HIV/AIDS was carried out in the first three months after antiretroviral therapy. The patients were divided into two groups by prognosis, the poor prognosis group and the non-poor prognosis group, and the CRP levels between the two groups were compared. Another two groups were classified according to the CRP level, one group with elevated CRP level and the other with normal CRP level, the rates of poor prognosis for the two groups were compared. Multivariate logistic regression analysis was performed to assess risk factors associated with poor prognosis. RESULTS The CRP level of the group with poor prognosis was 6.59（0.12--36. 12）mg/L, and 0.90 （0.00--5.90）mg/L of the group with non-poor prognosis, significant difference was seen between the two groups （P^0.05）. Totally 17 cases（14.4%） had poor prognosis in the group with normal level CRP, while 15 cases （44.1%） had poor prognosis in the other group with elevated CRP level, with significant difference between the two groups（P〈0.05）. The multivariate logistic regression analysis showed that the higher the baseline CRP, the higher risk the poor prognosis was（OR= 1. 025,95%CI： 1. 006--1. 044）. CONCLUSION HIV/AIDS patients with elevated CRP tend to have poor prognosis. The CRP level is an independent risk factor for the poor prognosis of the HIV/AIDS patients during the first three months after antiretroviral therapy.