艾滋病患者肺孢子菌肺炎相关危险因素分析

Related risk factors for Pneumocystis pneumonia in AIDS patients

目的探讨艾滋病患者发生肺孢子菌肺炎(PCP)的危险因素,以期早期识别PCP的发生。方法选择2013年10月-2014年11月117例艾滋病患者为研究对象,采用回顾性研究的方法,分析艾滋病发生与未发生PCP患者年龄、性别、发现HIV感染至入院间隔时间、抗病毒治疗、口腔真菌病、淋巴细胞、CD3+T细胞、CD4+T细胞、CD8+T细胞、NK细胞计数等指标,应用SPSS 19.0软件进行统计分析。结果单因素分析结果为发现HIV感染至入院间隔时间、抗病毒、口腔真菌病以及淋巴细胞、CD3+T细胞、CD4+T细胞表达水平在发生与未发生PCP患者中差异有统计学意义(P<0.05);多因素分析,CD4+T细胞以及发现HIV感染至入院间隔时间与PCP发生有关(P<0.05);抗病毒、口腔真菌病以及淋巴细胞、CD3+T细胞计数为混杂因素(P>0.05)。结论在HIV感染进入艾滋病期患者中,CD4+T细胞≤31.7个/μl、发现HIV感染至入院间隔平均时间≤3.5个月是预测PCP发生的较好指标。

OBJECTIVE To explore the risk factors for Pneumocystis pneumonia （PCP） in the AIDS patients so as to provide guidance for early identification of PCP .METHODS A total of 117 AIDS patients who were treated in the hospital from Oct 2013 to Nov 2014 were recruited as the study objects .A retrospective study was conducted , the indicators of the AIDS patients with PCP and the AIDS patients without PCP ,including the age ,gender ,in‐terval between onset of HIV infection and admission to hospital ,antifungal therapy ,oral fungal disease ,lympho‐cytes ,CD3 ＋ T cell ,CD4 ＋ T cell ,CD8 ＋ T cell ,and NK cell counts ,were observed ,and the statistical analysis was performed with the use of SPSS19 .0 software .RESULTS The results of the univariate analysis showed that there was significant difference in the interval between onset of HIV infection and admission to hospital ,antifungal ther‐apy ,oral fungal disease ,or level of lymphocytes ,CD3 ＋ T cell or CD4 ＋ T between the AIDS patients with PCP and the AIDS patients without PCP （P〈0 .05） .The multivariate analysis indicated that the PCP was associated with the CD4 ＋ T cell and the interval between onset of HIV infection and the admission to hospital （P〈0 .05） .The an‐tifungal therapy ,oral fungal disease ,and lymphocytes and CD3 ＋ T cell counts were the confounding factors （P〉0 .05） .CONCLUSION The no more than 31 .7/μl of CD4 ＋ T counts and no more than 3 .5 months of the interval between onset of HIV infection and admission to hospital are the good indicators for the prediction of PCP in the AIDS patients with HIV infection .