AIDS合并PSM患者临床特征及死亡危险因素分析

Analysis of clinical characteristics and risk factors of death in AIDS patients with PSM

目的分析获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)合并马尔尼菲青霉病(penicilliosis marneffei,PSM)患者的临床特征及死亡危险因素。方法回顾性分析2015年1月至2021年12月杭州市西溪医院收治的88例诊断为AIDS合并PSM患者的临床资料,了解AIDS合并PSM患者的临床特征,采用二元Logistic回归分析影响AIDS合并PSM患者死亡的相关因素。结果纳入患者平均年龄(37.34±11.24)岁,以男性为主(89.77%)。最常见的临床表现为发热。合并疾病由多到少依次为口腔念珠菌感染、巨细胞病毒感染、梅毒、结核、曲霉菌感染、慢性乙型肝炎、肺孢子虫病。死亡患者15例,占比17.05%。62.50%的患者CD4^(+)T淋巴细胞计数<20个/μl。消瘦、人类免疫缺陷病毒(human immunodeficiency virus,HIV)RNA≥10^(5)copies/ml均为AIDS合并PSM患者死亡的危险因素(P<0.05)。结论AIDS合并PSM患者的临床表现复杂、无特异性,易合并多种机会性感染。消瘦、HIV RNA≥10^(5)copies/ml的患者死亡风险增加,应引起高度重视。

Objective To investigate the clinical characteristics and risk factors of death in patients with acquired immunodeficiency syndrome(AIDS)combined with penicilliosis marneffei(PSM).Methods The clinical data of 88 patients diagnosed with AIDS combined with PSM admitted to Hangzhou Xixi Hospital from January 2015 to December 2021 were retrospectively analyzed to understand the clinical characteristics of AIDS combined with PSM.Binary Logistic regression was used to analyze the related factors affecting the death of AIDS patients with PSM.Results The patients were mainly male(89.77%),with an average age of(37.34±11.24)years.The most common clinical manifestation was fever.Complications of diseases in descending order were:oral candidiasis,cytomegalovirus infection,syphilis,tuberculosis,aspergillus infection,chronic hepatitis B,pneumocystosis.There were 15 dead patients,accounting for 17.05%.62.50%of patients had CD4^(+)T lymphocyte count<20 cells/μl.Weight loss and human immunodeficiency virus(HIV)RNA≥10^(5)copies/ml were risk factors for death in patients with AIDS combined with PSM(P<0.05).Conclusion The clinical manifestations of AIDS combined with PSM are complex and non-specific,and are prone to multiple opportunistic infections.Patients with weight loss and HIV RNA≥10^(5)copies/ml have an increased risk of death and should be taken seriously.