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中国真菌学杂志 2011, Vol. 6  Issue (3): 158-161.

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艾滋病合并马尔尼菲青霉病死亡的危险因素研究

欧汝志, 卢祥婵, 李伟新   

  1. 南宁市第四人民医院, 南宁, 530023
  • 收稿日期:2011-03-07 出版日期:2011-06-28 发布日期:2011-06-28
  • 通讯作者: 卢祥婵,E-mail:lxc5627257@126.com E-mail:lxc5627257@126.com
  • 作者简介:欧汝志,男(汉族),主治医师.E-mail:qwfyp2004@sina.com
  • 基金资助:
    广西壮族自治区卫生厅自筹经费科研课题(Z20100159)

Death risk factors in AIDS patients complicated with Penicilliosis marneffei

OU Ru-zhi, LU Xiang-chan, LI Wei-xin   

  1. The Fourth Hospital of Nanning, Nanning 530023
  • Received:2011-03-07 Online:2011-06-28 Published:2011-06-28

摘要: 目的 探讨艾滋病(AIDS)合并马尔尼菲青霉病(Penicilliosis marneffei,PSM)导致死亡的危险因素,从而减少死亡风险,改善预后。方法 选取我院2007~2010年期间101例AIDS合并PSM住院患者,根据其预后情况分为死亡组和存活组,比较两组年龄、性别、病程、发热、脐凹皮疹、腹痛、呼吸困难、消化道出血、腹膜刺激征、合并细菌性败血症、白细胞计数、血色素、血小板、血肌酐、丙氨酸转氨酶、门冬氨酸转氨酶、总胆红素、CD4+T淋巴细胞绝对计数、甘油三酯、真菌培养阳性报告时间、开始有效抗真菌治疗的时间、抗真菌治疗方案、是否HAART(高效抗逆转录病毒治疗)情况,进行统计学分析。结果 两组在腹痛、呼吸困难、消化道出血、腹膜刺激征、细菌性败血症、白细胞计数、血肌酐、总胆红素、门冬氨酸转氨酶、CD4+T淋巴细胞计数、甘油三酯、真菌培养阳性报告时间等因素的差异有统计学意义(P<0.05),多元逻辑回归显示,腹膜刺激征(OR=226.733)、呼吸困难(OR=90.213)、白细胞升高(OR=2.216)、血肌酐升高(OR=1.014)是AIDS合并PSM死亡的主要危险因素。结论 腹膜刺激征、呼吸困难、白细胞升高、肌酐升高是AIDS合并PSM死亡的主要危险因素,重视合并症治疗可能会降低死亡率。

关键词: 马尔尼菲青霉病, 死亡, 危险因素

Abstract: Objective To explore the death risk factors of Penicillium marneffei(PM) infection in AIDS patients for death risks reducing and prognosis improvement.Methods A total of 101 AIDS cases complicated with Penicilliosis marneffei(PSM) who had been hospitalized in our hospital between 2007 and 2010 were involved and divided into death group and survival group,according to prognosis.Indexes including age,sex,fever,periumbilical concave rash,bellyache,dyspnea,gastrointestinal hemorrhage,bacterial septicemia,the counts of WBC,HGB,PLT,CR,ALT,AST,T.BIL,absolute counting of CD4+ T lymphocytes,triglycerides,the time of positive fungus cultivation,beginning time of effctive antifungal therapy,regimen of antimycotic therapy,HAART(High active anti-retroviral therapy)accepted or not were compared and statistical analysis was carried out.Results Abdominal pain,dyspnea,gastrointestinal hemorrhage,peritoneal irritation sign,the counts of WBC,Cr,T.BIL,AST,CD4+ acounts,triglycerides,positive fungal culture time between two groups showed statistical significance(P< 0.05).The ORs of peritoneal irritation sign,dyspnea and WBC counting increasing in multivariate logistic regression were 226.733,90.213 and 2.216 respectively.The OR of elevated Cr was 1.014.Conclusions The peritoneal irritation sign,dyspnea,hoist of WBC counting,elevated Cr were the main death risk factors in AIDS patients complicated with PSM.Treatment of the complication may be helpful for mortality decreasing.

Key words: Penicilliosis marneffei, death, risk factors

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