广东地区345例HIV／AIDS患者死亡原因分析  

Analysis of death causes of 345 cases with HIV/AIDS in Guangdong area

作　　者：黄丽芬 唐小平 蔡卫平 雷春亮 张复春 陈伟烈 叶晓新[2] 

机构地区：[1]广州第八人民医院,510060 [2]广州医学院

出　　处：《中华实验和临床病毒学杂志》2013年第1期57-60,共4页Chinese Journal of Experimental and Clinical Virology

基　　金：艾滋病和病毒性肝炎等重大传染病防治科技重大专项“十一五”计划（2008ZX10001-006,2008ZX10001-008）;广州市重大科技攻关项目（200621-E0091）

摘　　要：目的探讨广东地区HIV／AIDS病例的死亡原因。方法对345例HIV／AIDS住院死亡病例进行回顾性分析。结果（1）2001年1月至2011年12月某医院HIV／AIDS住院患者3406例，死亡345例，病死率10．13％。自2005年实行免费抗病毒治疗以来，病死率较前下降。CD4^＋T淋巴细胞计数〈200个／μl者病死率为14．61％（299／2046），与≥200个／μl者之间差异有统计学意义（P〈0．01），随着CD4^＋下降，病死率上升。（2）机会性感染累及99．42％（343／345）死亡病例，共出现机会性感染924例次，与死亡直接相关的占84．64％。机会性感染以真菌和细菌感染最常见，感染部位以肺部、口腔、全身播散性、胃肠道、中枢神经系统感染、败血症、皮肤软组织感染为主，其中重症肺炎、播散性青霉菌病及中枢神经系统感染等艾滋病指征性机会性感染占29．65％。引起HIV／AIDS死亡的因素还有机会性肿瘤、HIV相关性疾病及艾滋病非相关性疾病等，占15．36％。无接受有效的高效抗逆转录病毒治疗（HARRT）亦构成死亡的因素，其中接受HARRT者疗程超过3个月只占6．96％。结论终末期艾滋病患者病死率极高，机会性感染是最主要的死亡原因。HIV／AIDS的早期诊断和积极控制机会性感染，及时有效HAART治疗是提高艾滋病患者生存质量的关键。Objective To analyze the death causes of 345 cases with HIV/AIDS in Guangdong area. Methods The situations of 345 hospitalized death cases with HIV/AIDS were conducted by retrospective analysis. Results （1）There were total 3406 hospitalized cases with HIV/AIDS in a hospital from January 2001 to December 2011 and 345 cases died, the fatality rate was 10. 13%. Since 2005 the introduction of free anti-viral treatment, the fatality rate of HIV/AIDS declined. The fatality rate of the patients whose CD4 ~ T lymphocyte counts 〈 200 cells/pal was 14.61% （299/2046） and it was significantly higher than that of patients whose CD4 ＋ T lymphocyte counts ~〉200 cells/pal （P 〈 0. 01 ）. （2） 99.42% of the death cases had more than one kind of opportunistic infections （OI） and there were 924 cases of OI totally. 84.64% of OI related to the death directly. Fungal infection was the most common in OI, followed by bacterial infection. Most OI occurred in the lungs, mouth, other systemic disseminated diseases, gastro - intestine, central nerver system, septicemia, skin. The AIDS defining opportunistic infections such as several pneumonia, disseminated penicilliosis marneffei and CNS infections accounted for 29. 65%. Other factors that caused HIV/AIDS death included opportunistic tumors, HIV related disease and non AIDS- related disease accounted for 15.36%. No accepted effective highly active antiretroviral therapy （HARRT） also constituted factors of death. Among cases which accepted HARRT treatment, only 6. 96% had the period of treatment over three months. Conclusion The fatality rate of end-stage AIDS patients was high and the opportunistic infections was the most important cause of death. Early diagnosis and treatment for opportunistic infections, timely effective HARRT were the key to improve the quality of life of AIDS patients.

关 键 词：获得性免疫缺陷综合征 机会性致病菌感染 CD4^+T淋巴细胞 

分 类 号：R512.91[医药卫生—内科学]