HIV阳性肺结核患者抗结核疗效多因素分析

Multivariate analysis of anti-tuberculosis efficacy in human immunodeficiency virus-positive tuberculosis patients

目的分析艾滋病病毒(HIV)阳性肺结核患者抗结核疗效影响因素,探索其影响因素预测指标。方法收集2019年1月至2022年2月在石家庄市第五医院诊治的64例HIV阳性肺结核患者病例资料。根据抗结核治疗6个月疗效分为有效组和无效组。比较2组研究对象一般资料、实验室指标的差异。通过二元Logistics回归分析HIV阳性肺结核患者抗结核疗效的影响指标。通过ROC曲线分析HIV阳性肺结核抗结核疗效的预测指标及诊断效能。结果单因素分析结果显示,抗结核治疗有效组和无效组血清白蛋白(ALB)、血红蛋白(HGB)、淋巴细胞计数(LYM%)、中性粒细胞(NEUT)、天冬氨酸氨基转移酶(AST)、C-反应蛋白(CRP)、CD4计数差异有统计学意义(均P<0.05)。Logistics回归分析结果显示,HGB和CD4细胞越低HIV阳性肺结核抗结核无效的风险越高。ROC曲线结果显示,CD4细胞计数、HGB、两者联合均可用于预测HIV阳性肺结核抗结核疗效,其AUC分别为0.838、0.843和0.911。结论CD4细胞、HGB是HIV阳性肺结核患者抗结核疗效的重要影响因素,二者联合应用可有效预测HIV阳性肺结核患者抗结核疗效。

Objective To analyze the influencing factors for the anti-tuberculosis efficacy on human immunodeficiency virus(HIV)-positive pulmonary tuberculosis patients,and to explore the predictive indicators for the influencing factors.Methods Data of 64 HIV-positive pulmonary tuberculosis patients diagnosed and treated in Shijiazhuang Fifth Hospital from January 2019 to February 2022 were collected.Patients were assigned into the effective group and ineffective group according to the 6-month efficacy of anti-tuberculosis treatment.Differences in the general data,and laboratory parameters between the two groups were compared.Influencing factors for the anti-tuberculosis efficacy on HIV-positive pulmonary tuberculosis patients were identified by binary logistic regression.Predictors of anti-tuberculosis efficacy and diagnostic efficacy in HIV-positive pulmonary tuberculosis were analyzed by plotting the receiver operating characteristic(ROC)curves.Results The results of univariate analysis showed significant differences in serum albumin(ALB),hemoglobin(HGB),lymphocyte percentage(LYM%),neutrophils(NEUT),aspartate aminotransferase(AST),C-reactive protein(CRP),and CD4+cell count between effective group and ineffective group(all P<0.05).Logistic regression analysis results showed that low HGB and CD4+cell count predicted a high risk of ineffective anti-tuberculosis in HIV-positive pulmonary tuberculosis patients.ROC curve showed that CD4+cell count,HGB,and their combination were able to predict the anti-tuberculosis efficacy in HIV-positive pulmonary tuberculosis patients,with the area under the curve(AUC)of 0.838,0.843 and 0.911,respectively.Conclusion CD4+cell count and HGB are important predictors for the anti-tuberculosis efficacy in HIV-positive pulmonary tuberculosis patients,and their combined detection can effectively predict the efficacy.