结核分枝杆菌艾滋病病毒双重感染者死亡风险因素分析

Death risk factors of tuberculosis patients co-infected with human immunodeficiency virus

目的探讨结核分枝杆菌艾滋病病毒双重感染者死亡的风险因素。方法对2015年1月至2016年3月确证,接受检测和随访的120例结核分枝杆菌艾滋病病毒双重感染者的病例资料、随访信息、临床基本信息、CD4+T淋巴细胞水平及抗病毒治疗情况与死亡风险的相关性进行分析。结果静脉吸毒方式感染艾滋病病毒患者病死率明显高于性传播感染者(34.09%vs 14.47%,χ~2=5.967,P<0.05);年龄越小,文化程度越高,CD4+T淋巴细胞水平越高的感染者其病死率越低(P<0.05);已婚或同居感染者的病死率(15.00%)明显低于未婚(25.00%)、离异或丧偶感染者(21.88%)(χ~2=6.127,P<0.05);未采取抗病毒治疗的感染者病死率显著高于接受抗病毒治疗的感染者,采取抗病毒治疗越早,则感染者病死率越低(P<0.05)。结论年龄、文化程度、CD4+T淋巴细胞水平、感染方式、是否接受抗病毒治疗、不同抗病毒治疗时间是引起结核分枝杆菌艾滋病病毒双重感染者死亡的风险因素。

Objective To study the death risk factors of tuberculosis patients co-infected with human immunodeficiency virus（HIV）. Methods A total of 120 cases with Mycobacterium tuberculosis and HIV coinfections were recruited to follow up their clinical outcomes. Results The mortality rate of cases infected through intravenous drug injections was significantly higher than that through sex transmission（34.09% vs14.47%,χ^2=5.967,P〈0.05）;the lower the age,the higher the education level and higher CD4^＋T lymphocyte count,the lower the death rate（P〈0.05）.The mortality rates of married cases or at companionate marriage status（15.00%）were significantly lower than those of unmarried（25.00%）,divorced or widowed ones（21.88%）（χ^2=6.127,P〈0.05）.The cases without antiviral treatment showed significantly higher mortality rate than those with antiviral treatment.The earlier the cases received antiviral treatment,the lower the mortality rate（P〈0.05）. Conclusions Age,education level,CD4^＋T lymphocyte number,infection routes,receiving antiviral treatment or not,different antiviral treatment time were all death risk factors for cases with co-infection of Mycobacterium tuberculosis and HIV.