艾滋病并发血流感染的临床分析  

Bloodstream Infections among AIDS Patients

作　　者：励峰[1] 朱翠云[2] 黄琴[2] 孙洪清[2] 

机构地区：[1]上海市静安区曹家渡社区卫生服务中心,200042 [2]上海市公共卫生临床中心感染科

出　　处：《医学研究杂志》2012年第12期32-35,共4页Journal of Medical Research

基　　金：国家科技重大专项基金资助项目(2008ZX10001-008);卫生部艾滋病防治研究基金资助项目(WA-2007-05)

摘　　要：目的探讨艾滋病患者血流感染的病原菌分布,与外周血细胞的相关性及其对预后的影响。方法回顾性分析2011年1月～2012年3月在上海市公共卫生临床中心感染科住院的艾滋病并发血流感染的发病率、病原菌分布、与外周血细胞、外周血淋巴细胞计数的相关性以及病死率。结果 144例艾滋病患者中确诊血流感染(血流感染组)有19.4%(28/144),无血流感染(无血流感染组)有80.6%(116/144)。培养出33株病原菌,主要是葡萄球菌8株(24.2%);真菌6株(18.2%);沙门菌6株(18.2%)。血流感染组平均红细胞计数及血红蛋白分别为3.223×1012/L、98.89g/L,无血流感染组分别为3.678×1012/L、109.94g/L,差异有统计学意义(P分别为0.016和0.049)。血流感染组CD4+T淋巴细胞计数78.3×106/L,无血流感染组CD4+T淋巴细胞计数98.75×106/L,两组比较差异无统计学意义(P=0.422)。血流感染组病死率32.1%,无血流感染组病死率12.1%,两组比较差异有统计学意义(χ2=6.772,P=0.009)。结论艾滋病患者并发血流感染的病原菌以葡萄球菌为常见,外周红细胞和血红蛋白低更易并发血流感染,且病死率高。需要积极防治血流感染的发生。Objective To analyze the bloodstream infections（BSI） among AIDS patients,and study its peripheral blood routine test,its pathogens distribution, and its influence to prognosis. Methods A retrospective cohort study was conducted among 144 AIDS inpa- tients from January 2011 to March 2012 in Shanghai Public health center of Fudan University. Results All of 144 cases, the incidence rate of BSI was 19.4% （28/144）. The blood cuhures contained 33 different pathogens, with 8 staphylococcus strains （24.2%） ,6 fungi strains （ 18.2% ） ,6 salmonella strains（ 18.2% ）. The peripheral red blood cell count and haematoglobin were 3. 223×1012/L,98.89g/L in patients with BSI and were 3. 678×1012/L, 109.94g/L in patients without BSI （P = 0. 016 and 0. 049）. The peripheral blood CD4＋ lymphocyte counts were 78.3×106/L in patients with BSI and were 98.75×106/L in patients without BSI （ P = 0. 422）. The mortality of BSI and non - BS1 was 32.1% and 12.1% （χ2 = 6. 772, P = 0. 009）. Conclusion The AIDS patients with BSI had a lower red blood cell count and haematoglobin than non - BSI. The common pathogens of BSI were staphylococcus among AIDS patients in our hospital. AIDS patients with BSI had a high rate of mortality. It is necessary to prevent the happening of BSI.

关 键 词：艾滋病患者 外周血淋巴细胞计数 血流感染 

分 类 号：R512.91[医药卫生—内科学]