| 血清白蛋白对艾滋病合并重度肺孢子菌肺炎患者预后的评估价值 |
| 投稿时间：2016-10-27 修订日期：2016-11-02 点此下载全文 |
| 引用本文：李爱新,黄春洋,张宏伟,张彤,吴昊,汪雯.血清白蛋白对艾滋病合并重度肺孢子菌肺炎患者预后的评估价值[J].医学研究杂志,2017,46(6):129-132,139 |
| DOI：
10.11969/j.issn.1673-548X.2017.06.033 |
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| 中文摘要:目的 探讨血清白蛋白水平对艾滋病（AIDS）合并重度肺孢子菌肺炎（PCP）患者预后的评估价值。方法 回顾性分析首都医科大学附属北京佑安医院感染科2008年1月~2015年12月收治的AIDS合并重度PCP患者的临床资料，根据住院期间是否死亡将患者分为存活组和死亡组。收集两组患者的一般资料及实验室检测结果，采用多因素Logistic回归分析筛选出影响患者预后的独立危险因素，绘制受试者工作特征曲线（ROC）对其预后价值进行评估。结果 共纳入94例AIDS合并重度PCP患者，男性88例，女性6例，患者平均年龄40.3±11.4岁；CD4计数0~289个/微升，中位数15个/微升。存活组43例，死亡组51例。死亡组患者年龄明显高于存活组（P<0.05）；而CD4计数、动脉氧分压（PaO2）、血氧饱和度（SpO2）以及血清白蛋白（ALB）水平明显低于存活组（P<0.05），多因素Logistic回归分析显示血清ALB是影响AIDS合并重度PCP患者预后的独立危险因素（P=0.000）。血清ALB水平对AIDS合并重度PCP预后的ROC曲线下面积0.944（95%可信区间：0.890~0.998），P=0.000，血清白蛋白<25.8g/L提示预后不良的敏感度为90.7%，特异性为94.1%。结论 AIDS合并重度PCP病死率高，血清白蛋白水平与其预后具有一定相关性，发生低蛋白血症会增加AIDS合并重度PCP患者的死亡风险，故监测血清白蛋白水平对评估患者预后具有重要意义。 |
| 中文关键词:艾滋病 肺孢子菌肺炎 血清白蛋白 预后 |
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| Prognostic Value of Serum Albumin in AIDS Patients with Severe Pneumocystis Pneumonia |
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| Abstract:Objective To investigate the predictive value of serum albumin in AIDS patients with severe pneumocystis pneumonia(PCP). Methods The clinical data of AIDS patients with severe PCP admitted in the Department of Infectious Diseases, Beijing YouAn Hospital, Capital Medical University from January 2008 to December 2015, were retrospectively analyzed. The patients were divided into death group and survival group according to clinical outcome during hospitalization. Data of the two groups were collected including general information and laboratory test results. Multivariate Logistic regression was used to select independent risk factors affecting prognosis of patients, and draw the receiver operating characteristic curve (ROC) to assess their prognostic value. Results A total of 94 cases of AIDS in patients with severe PCP were studied. 88 were male and 6 were female, with a mean age of 40.3±11.4 years. CD4 counts were from 0 to 289/μl, with a median of 15/μl. There were 43 patients in the survival group and 53 patients in the death group. Age was significantly higher in the death group than those in the survival group (P<0.05), and CD4 count, PaO2, SpO2, and ALB levels were significantly lower in the death group than those in the survival group (P<0.05). Multivariate Logistic regression analysis showed that ALB was independent prognostic factors of AIDS complicated with severe PCP (P=0.000). The area under the ROC curve of prognosis of AIDS patients with severe PCP was 0.944 (95% CI:0.890-0.998), with P value of 0.000. By using 25.8g/L as cut-off value,the sensitivity was 90.7% and the specificity was 94.1% for predicting death. Conclusion AIDS patients with severe PCP has a high mortality rate, serum albumin level and its prognosis had a certain correlation. The occurrence of hypoalbuminemia would increase the risk of mortality in AIDS patients with severe PCP. Monitoring of serum albumin level might be beneficial to evaluate the prognosis. |
| keywords:AIDS Pneumocystis pneumonia Serum albumin Prognosis |
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