HIV合并重症肺炎临床与预后因素分析

目的：探讨和分析HIV合并重症肺炎患者的临床表现及预后因素。方法：选取2011年1月-2013年12月本院收治的HIV合并重症肺炎患者51例为研究对象,依据患者预后实际情况分成存活组和死亡组;分析两组患者混合感染情况及临床病因,总结影响预后的相关因素。结果：HIV合并重症肺炎的病原谱主要以肺孢子菌、细菌、TB、真菌为主;预后行单因素分析,发现两组患者血LDH浓度水平、机械通气率、住院时间等指标比较差异均有统计学意义（P〈0.05）;行Logistic回归分析显示,合并基础病症、机械通气、最低白蛋白水平以及LDH异常是影响HIV合并重症肺炎患者预后的主要危险因子,也是导致患者存活率的主要因素。结论：HIV合并重症肺炎病原谱主要以肺孢子菌、细菌、TB为主,其中血LDH异常升高、高机械通气率、低蛋白水平以及合并基础病症是导致患者预后不佳的主要危险因子,针对上述因素应行相应的干预和治疗,这对缓解病情恶化,改善患者临床及预后有着积极的意义。

HIV Patients with Severe Pneumonia Clinical and Prognostic Factor Analysis

Objective：To investigate and analyze the merger HIV patients with severe pneumonia clinical manifestations and prognostic factors.Method：January 2011 December 2013 merger HIV patients admitted to hospital with severe pneumonia 51 cases for the study, based on the actual situation into survival prognosis group and death group; analysis of the two groups were mixed infection and clinical etiology, summarize relevant prognostic factors.Result：HIV complicated by severe pneumonia pathogen spectrum mainly Pneumocystis, bacteria, TB, fungal-based; prognostic univariate analysis, serum LDH levels found two groups of patients, the rate of mechanical ventilation, length of stay and other indicators differences were statistically significant（P〈0.05）; Logistic regression analysis showed that a consolidated basis disease, mechanical ventilation, low albumin levels and abnormal LDH are the main risk factors for severe pneumonia in patients with HIV prognosis merger, was a major factor leading to the survival of patients.Conclusion： HIV patients with severe pneumonia pathogen spectrum mainly Pneumocystis, bacteria, TB based, which abnormally elevated blood LDH, high ventilation rates, low protein levels and disease on a consolidated basis is a major cause of poor prognosis of patients with risk factors, these factors should be performed for appropriate intervention and treatment, which is to alleviate disease progression and improve clinical outcomes in patients with a positive meaning.