艾滋病合并肺孢子菌肺炎机械通气的危险因素分析  

Risk factors of mechanical ventilation for pneumocystis pneumonia in AIDS patients

作　　者：陈跃华[1] 陆宁[1] 刘升[1] 覃鸿发[1] 韦静[1] 林艳荣[1] CHEN Yue-hua;LU Ning;LIU Sheng;QIN Hong-fa;WEI Jing;LIN Yan-rong(Department of Critical Medicine,Guangxi Center for AIDS Treatment,the Fourth People＇s Hospital of Nanning,Nanning,Guangxi 530023,China)

机构地区：[1]南宁市第四人民医院广西艾滋病临床治疗中心(南宁)重症医学科,广西南宁530023

出　　处：《临床肺科杂志》2018年第10期1760-1763,共4页Journal of Clinical Pulmonary Medicine

基　　金：广西壮族自治区南宁市科学研究与技术开发计划项目(No 20153121)

摘　　要：目的探讨艾滋病(AIDS)合并肺孢子菌肺炎(PCP)患者机械通气的危险因素。方法回顾性分析2016年1月至2017年10月我院收治的AIDS合并PCP患者111例,分析机械通气组(36例)与未进行机械通气组(75例)患者的一般情况、入院后24小时内检查结果及住院期间的合并症。所有收集资料通过单因素分析,具有统计学意义者纳入logistic回归分析。结果单因素分析结果提示,两组患者的体温、氧合指数、血乳酸脱氢酶、白蛋白、合并巨细胞病毒感染及接受高效抗反转录病毒治疗(HAART)等指标具有显著性差异(P<0.05)。进一步Logistic回归分析结果表明,氧合指数、血乳酸脱氢酶及HAART是AIDS合并PCP患者需行机械通气的主要危险因素。结论对于未行HAART的AIDS合并PCP患者,需注意监测其氧合指数、血乳酸脱氢酶,尽早甄别重症病例,及时采用机械通气,改善预后,降低死亡率。Objective To explore the risk factors of mechanical ventilation for pneumocystis pneumonia（PCP） in AIDS patients.Methods A total of 111 AIDS combined with PCP patients in our hospital from Jan 2016 to Oct 2017 were retrospectively analyzed.The indicators of the patients with mechanical ventilation（36 cases） and non-mechanical ventilation（ 75 cases） were analyzed,including the general situation,examination results in 24 hours and complications during hospitalization by univariate analysis.Logistic regression analysis was included in the statistical significance.Results Univariate analysis showed that body temperature,oxygenation index,blood lactate dehydrogenase,albumin,cytomegalovirus infection and highly effective antiretroviral therapy（ HAART） were significantly different between the two groups（ P〈0.05）.Further logistic regression analysis showed that oxygenation index,blood lactate dehydrogenase and HAART were the major risk factors for mechanical ventilation in AIDS combined with PCP patients.Conclusion For AIDS combined with PCP patients without HARRT,it is necessary to monitor the oxygenation index and blood lactate dehydrogenase,and early screening of severe cases and timely using mechanical ventilation can improve prognosis and reduce mortality.

关 键 词：艾滋病 肺孢子菌肺炎 机械通气 氧合指数 乳酸脱氢酶 

分 类 号：R512.91[医药卫生—内科学]