艾滋病与结核病共感染患者肺结核治疗期间死亡的相关因素分析

Factors Associated with Death during Tuberculosis Treatment of Patients with co-infection of HIV and TB

目的 :探讨人类免疫缺陷病毒(HIV)/结核(TB)共感染患者结核病首次治疗后6个月内死亡的相关因素。方法 :回顾性分析2016年1月～2017年12月在遵义医学院附属医院接受结核病治疗的337例15岁以上的HIV/TB共感染患者的临床资料。死亡是指HIV/TB患者首次接受肺结核治疗后6个月内发生的任何原因死亡。采用单因素和多因素分别筛选影响死亡的相关危险因素。结果 :337例患者平均年龄39.3±10.3岁,54.3%为女性。结核病治疗结果如下:223例(66.1%)治疗成功,99例(29.4%)死亡,15例(4.5%)失访。HIV/TB患者首次接受肺结核治疗后6个月内死亡的影响因素包括:伴艾滋病定义性疾病、伴非艾滋病共症、未接受复方新诺明预防、未接受抗逆转录病毒治疗、CD4细胞计数<50个细胞/mm3。结论 :HIV/TB共感染患者结核病治疗成功率低,治疗期间死亡率高,并且与临床和生物学因素密切相关,需要根据患者个体因素进行针对性干预。

Objective To assess factors associated with death in TB/HIV co-infected patients during the initial 6 months of TB treatment.Methods Retrospectively analyzed the clinical data of 337 patients with HIV/TB co-infection aged over 15 who received TB treatment in the affiliated hospital of zunyi medical college from January 2016 to December 2017.Death is any cause of deathof an HIV/TB patient within 6 months of the first treatment for tuberculosis.The univariate and multiple logistic regression analyses were used to screen the related risk factors of death.Results The mean age of weatment outcomes were distributed as follows:337 patients was 39.3+10.3 years and 54.(3 percent ere female.TB trh in TB/HIV co-infected patients during TB tre2 a2 tm3(e6 n6.t 1%)treatment success,was associated with the p9 r9(es2 e9.n4%)deaths,ce of other A1 ID5 S4.-5%)lost to follow-up.Deatdefining diseases,non-AIDS comorbidities,not receiving cotrimoxazole prophylaxis,not receiving antiretroviral therapy,and CDunt,e TB treatment success rate among TB/HIV co-infected patients is low.Mortality wa4 cells co50 cells/mm3.Conclusion Ths high among TB/HIV co-infected patients during TB treatment and is strongly associated with clinical and biological factors,highlighting the urgent need for specific interventions focused on enhancing patient outcomes.