【摘要】 目的探讨C-反应蛋白(CRP)对人免疫缺陷病毒感染者/艾滋病患者(HIV/AIDS)抗病毒治疗前病情的判断及抗病毒治疗6个月预后的预测价值。方法选择301例HIV/AIDS患者,在抗病毒治疗前检测CRP,采用受试者工作特性曲线(ROC曲线)估计CRP对HIV/AIDS病情的判断价值。抗病毒治疗并观察6个月,采用ROC曲线估计CRP对HIV/AIDS死亡的预测价值。比较不同CRP水平组生存率,采用多因素Cox回归模型分析CRP水平对生存时间的影响。结果 CRP对病情判断的ROC曲线下面积(AUC)为0.711(95%CI:0.652~0.769,P<0.05)。随访6个月,死于艾滋病相关疾病者42例,CRP较低组生存率为91.9%,CRP较高组生存率为79.3%,差异具有统计学意义(χ2=9.893,P<0.05)。CRP对死亡预测的AUC为0.682(95%CI:0.586~0.777,P<0.05)。多因素Cox回归分析结果显示,CRP水平越高,死亡危险度越大(OR=1.010,95%CI:1.001~1.019)。结论 CRP对HIV/AIDS病情有较高的判断价值,对抗病毒治疗早期死亡有一定预测价值。更多还原

【Abstract】 Objective To investigate the value of C-reactive protein(CRP) in assessing illness severity before antiretroviral therapy(ART) and to predicte the prognosis for human immunodeficiency virus/acquired immunodeficiency syndrome patients with(HIV/AIDS) during six months after ART. Methods Total of 301 patients with HIV/AIDS were selected and the levels of serum CRP were examined. The value of CRP for assessing illness severity was analyzed by the receiver operative characteristics curve(ROC curve). Then, all patients were received ART and followed up for six months. The value of CRP for predicting death after ART was calculated by ROC curve. The survival rates were compared among the groups with different CRP levels. The risk factors for survival time was analyzed by the multivariable Cox regression model. Results The area of under the ROC curve(AUC) for CRP in assessing illness severity was 0.711(95%CI: 0.652-0.769, P < 0.05). After six months follow-up, there were 42 cases died of AIDS-related disease. The survival rate was 91.9% for the lower CRP group and 79.3% for the higher one, with significant difference(χ2 = 9.893, P < 0.05). The AUC for CRP in evaluating death after ART was 0.682(95%CI: 0.586-0.777, P< 0.05). The multivariable Cox regression model analysis showed that higher CRP level was associated with greater risk of death(OR = 1.010, 95%CI: 1.001-1.019). Conclusions CRP is of high value for assessing illness severity and of useful value for predicting death in the early-stage of ART.更多还原