【摘要】 目的探讨影响AIDS合并播散性马尔尼菲青霉菌病(DPsM)预后的因素。方法应用Logistic回归方法对124例AIDS合并DPsM患者的临床和实验室资料进行回顾性分析,筛选出独立预后因素。结果 124例AIDS合并DPsM患者的病死率为29.84%。单因素分析结果显示,影响AIDS合并DPsM预后的因素包括:血白细胞计数、总胆红素、白蛋白、尿素氮、肌酐、CD4+T细胞计数、肝脾大、吸毒或酗酒、抗反转录病毒治疗及激素的使用。多因素分析显示尿素氮(OR0=0.584,95%CI 0.369～0.925)是AIDS合并DPsM死亡的危险因素,而CD4+T细胞计数(OR=1.364,95%CI 1.038～1.792)与抗反转录病毒治疗(OR=17.084,95%CI 5.297～71.668)是其保护性因素。结论尿素氮增高是AIDS合并DPsM预后不良的危险因素,较高的CD4+T细胞计数和抗反转录病毒治疗则可减少死亡风险,改善预后。更多还原

【Abstract】 Objective To explore the prognostic factors of disseminated Penicilliosis Marneffei(DPsM)in patients with acquired immunodeficiency syndrome(AIDS).Methods 124 cases of AIDS complicated with DPsM were evaluated by logistic regression analysis in order to determine independent prognostic factors.Results 124 cases with a mortality rate of 29.84%.In the univariate analysis,10 variables associated significantly with the prognosis of AIDS complicated with DPsM.These variables included leukocyte count,total bilirubin,the serum albumin level,blood urea nitrogen,creatinine,CD4+T lymphocyte count,hepatosplenomegaly,drug abuse or excessive drinking,antiretroviral therapy and using of hormone.Multivariate logistic regression analysis showed the increase of BUN(OR=0.584,95%CI 0.369-0.925)was risk factor related to the mortality of AIDS patients with DPsM,meanwhile,CD4+T lymphocyte count(OR=1.364,95%CI 1.038-1.792)and antiretroviral therapy(OR=17.084,95%CI 5.297-71.668)provided protective effect.Conclusion The increase of BUN is the risk factors contributing to the poor prognosis of AIDS patients with DPsM,while CD4+T lymphocyte count or antiretroviral therapy can reduce the mortality and improve the prognosis.更多还原