艾滋病合并巨细胞病毒感染特点及危险因素的研究  

Characteristics of AIDS complicating cytomegalovirus infection and the risk factors

作　　者：张莉[1] ZHANG Li(Xianning Municipal Center for Disease Control and Prevention,Xianning,Hubei 437000,China)

机构地区：[1]湖北省咸宁市疾病预防控制中心检验科,湖北咸宁437000

出　　处：《国际检验医学杂志》2018年第3期293-295,299,共4页International Journal of Laboratory Medicine

基　　金：湖北省科学技术厅项目(EK2012D220013001669)

摘　　要：目的探讨艾滋病(AIDS)合并巨细胞病毒(CMV)感染的特点及危险因素。方法选取2014年3月至2017年2月该疾控中心确证的AIDS患者198例,并将其分为试验组(AIDS合并CMV感染患者100例)和对照组(AIDS患者98例),回顾性分析AIDS合并CMV感染的临床特点和危险因素。结果试验组中,CMV DNA阳性率为82.00%,CMV-IgM阳性率为12.00%,CMV DNA、CMV-IgM均为阳性的阳性率为6%;单纯CMV血症占52.00%,CMV视网膜炎占19.00%,CMV肺炎占16.00%,CMV肠炎占7.00%,CMV脑膜炎占5.00%,CMV肝炎占1.00%。结果试验组中,经性传播感染、CD4+T淋巴细胞计数≤50个/μL、合并结核感染、合并肺孢子虫感染、合并口腔真菌感染的患者比例明显高于对照组,而首次就诊率、经抗反转录病毒治疗的患者比例和住院时间明显低于对照组,差异有统计学意义(P<0.05)。进一步多因素回归分析结果显示,CD4+T淋巴细胞计数≤50个/μL、合并肺孢子虫感染、合并口腔真菌感染是AIDS合并CMV感染的独立危险因素,而抗反转录病毒治疗是其保护因素。结论 AIDS合并CMV感染的发病率较高,其可引发多器官损伤,临床应注意高危患者的早期筛查。Objective To investigate the features and related risk factors of AIDS complicating cytomegalovirus(CMV)infection.Methods A total of 198 patients with AIDS confirmed by this center from March 2014 to February 2017 were selected and divided into the experiment group(100 cases of AIDS complicating CMV infection)and control group(98 cases of AIDS).Then the features and risk factors of AIDS complicating CMV were retrospectively analyzed.Results In the experiment group,the CMV DNA positive rate was 82.00%,the CMV-IgM positive rate was 12.00%,the positive rate of CMV DNA and CMV-IgM was 6%;the simple CMV viremia accounted for 52.00%,CMV retinitis for 19.00%,CMV pneumonia for 16.00%,CMV enteritis for 7.00%,CMV meningitis for 5.00%and CMV hepatitis for 1.00%.In the experiment group,the proportions of the patients with sexually transmitted infection,CD4+T lymphocyte count≤50/μL,complicating TB infection,complicating Pneumocystis carinii infection and complicating oral fungal infection were significantly higher than those in the control group,while the first visiting rate,proportion of the patients with antiretroviral therapy and hospitalization time were significantly lower than those in the control group,the difference was statistically significant(P<0.05).The further multivariate regression analysis results found that CD4+T lymphocytes count≤50/μL(OR=3.425,95%CI:2.451-6.687),complicating Pneumocystis carinii infection(OR=4.937,95%CI:2.417-9.014)and complicating oral fungal infection(OR=2.994,95%CI:1.987-5.467)were the independent risk factors for AIDS complicating CMV infecttion,while antiretroviral therapy was its protective factor.Conclusion AIDS complicating CMV infection has a higher incidence rate,which can cause multiple organ damage,therefore clinic should highly pay attention to early screening of high-risk patients.

关 键 词：艾滋病 巨细胞病毒 危险因素 

分 类 号：R446.5[医药卫生—诊断学]