艾滋病合并马尔尼菲青霉菌病患者死亡危险因素分析

目的探讨艾滋病(AIDS)合并马尔尼菲青霉菌病(PSM)的死亡危险因素。方法采用病例对照研究方法,调查2008-01～2009-12广西壮族自治区龙潭医院收治住院的307例AIDS合并PSM患者,通过单因素和多因素非条件Logistic回归分析筛选出导致患者死亡的危险因素。结果 AIDS合并PSM 307例患者中,生存组226例,死亡组81例,死亡率为26.38%。单因素Logistic回归分析显示,感染途径、治疗方案、是否接受过高效抗反转录病毒(HAART)治疗、合并细菌或其它真菌性肺炎、合并耶氏肺孢子虫肺炎(PCP)、中毒性肝炎、白细胞减少、血小板减少、白蛋白减少、血尿素氮升高、血清总胆红素升高等16个因素为死亡的影响因素。多因素分析结果显示,实施氟康唑治疗方案及两性霉素B治疗方案是预后的保护因素,合并PCP、血小板减少、血尿素氮升高、总胆红素升高是死亡的危险因素。结论通过对死亡危险因素的研究,可有针对性采取有效治疗和控制措施.对降低死亡率有重要意义。

An analysis of risk factors for death in AIDS patients complicated with Penicilliosis Marneffei

Objective To explore the risk factors for death in AIDS patients complicated with in Penicilliosis Mameffei(PSM).Methods Using the historical cohort study method,Three hundred and seven cases of AIDS patients complicated with Penicilliosis marneffei treated in Guangxi Longtan hosipital from January 2008 to December 2009 were investigated,a multivariate Logistic regression analysis was used for screening the risk factors for death. Results There were 226 patients in the survival group and 81 patients in the death froup,with a mortality rate of 26.38%,including 11 patients with relapse,with recurrence rate of 3.58%.The univariate logistic regression analysis showed;routes of infection,treatment options,HAART treatment,complicated with bacterial or other fungal pneumonia,complicated with Pneumocystis carinii pneumonia(PCP),toxic hepatitis,leukopenia,thrombocytopenia, decreased albumin,elevated blood urea nitrogen,serum total bilirubin were associated with risk factors for death.The multiple factors analysis showed,implementation of fluconazole and amphotericin B treatment scheme was protective factors;complicated with PCP,thrombocytopenia,elevated blood urea nitrogen,total bilirubin was high risk factors.Conclusion It will be significant to reduce the mortality in the future through this study,which will provide some suggestion to take effective treatment and control measures for the doctors.