中华灾害救援医学2024，Vol.11Issue(2)：134-137,152,5.DOI:10.13919/j.issn.2095-6274.J202401011
艾滋病合并急性间质性肺炎预后影响因素分析
Analysis of Risk Factors of Prognosis and Protective Factors of Treatment in AIDS Patients with Acute Interstitial Pneumonia
摘要
Abstract
Objective To explore the risk factors that affect the prognosis of AIDS patients with acute interstitial pneumonia and the treatment methods that are beneficial to the prognosis of patients in the course of treatment.Methods The clinical data of 89 hospitalized patients with AIDS complicated with acute interstitial pneumonia were collected.The final definition of the event was"deterioration/improvement"of the treatment outcome.A univariate analysis was conducted on the 17 factors that may have an impact on the deterioration of patient prognosis before treatment,including the patient's age,gender,blood pressure,temperature,respirator y rate,pulse,hemoglobin,blood plate count,CD4+T lymphocyte count,glutamic oxaloacetic transaminase,lactate dehydrogenase,serum albumin,C-reactive protein,oxygenation index,serum cytomegalovirus DNA test results,pulmonary tuberculosis screening results,and fungal(1,3)-β-D-glucan test results,as well as the 5 treatment methods that may be beneficial for improving patient prognosis,including early absolute bed rest,early adequate respiratory support,early active correction of hypoalbuminemia,early use of amphotericin B,and early use of glucocorticoids.Individuals with statistical differences for inclusion in logistic regression analysis were screened to explore risk factors that affect patient prognosis in the early stages of treatment and treatment methods that are beneficial for patients.Results Among the 89 patients who underwent active treatment,71(79.8％)had improved prognosis and 18(20.2％)had worsened prognosis.The results of multiple logistic regression analysis showed that pre-treatment blood pressure,lactate dehydrogenase(LDH),oxygenation index,blood cytomegalovirus DNA,and fungal(1,3)-β-D-glucan test results were all risk factors affecting the patient's prognosis(P＜0.05);Whether sufficient respiratory support can be provided in the early stage of treatment,correcting hypoproteinemia,and using amphotericin B(AMB)antifungal therapy are protective factors that affect patient prognosis(P＜0.05).Conclusion Low blood pressure,abnormal elevation of lactate dehydrogenase,decreased oxygenation index,positive blood cytomegalovirus DNA,and positive fungal(1,3)-β-D-glucan test before treatment are risk factors for poor treatment efficacy and poor prognosis in patients;Early treatment with sufficient respiratory support,active correction of hypoproteinemia,and active antifungal therapy can achieve better therapeutic effects.关键词
获得性免疫缺陷综合征/肺炎/预后Key words
Acquired Immune Deficiency Syndrome/Pneumonia/Prognosis分类
医药卫生引用本文复制引用
陆鹏..艾滋病合并急性间质性肺炎预后影响因素分析[J].中华灾害救援医学,2024,11(2):134-137,152,5.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190993) （Z20190993）
