中国北方部分地区人类免疫缺陷病毒合并播散性鸟分枝杆菌复合群感染者的临床特征及预后影响因素  

Clinical characteristics and influencing factor of prognosis of human immuno-deficiency virus combined with disseminated Mycobacterium avium complex patients in parts of northern China

作　　者：魏华英 王立静[2] 崔晓 杨洋 陈雪[1] 马萍[3] 张玉林[1] WEI Huaying;WANG Lijing;CUI Xiao;YANG Yang;CHEN Xue;MA Ping;ZHANG Yulin(Department of Respiratory and Infectious Diseases,Beijing Youan Hospital,Capital Medical University,Beijing100069,China;Department of Infectious Disease,Shijiazhuang Fifth Hospital,Hebei Province,Shijiazhuang050024,China;the Second Department of Infectious Disease,Tianjin Second People’s Hospital,Tianjin300192,China)

机构地区：[1]首都医科大学附属北京佑安医院感染与呼吸疾病科,北京100069 [2]石家庄市第五医院感染科,河北石家庄050024 [3]天津市第二人民医院感染二科,天津300192

出　　处：《中国医药导报》2022年第28期102-105,110,共5页China Medical Herald

基　　金：国家自然科学基金资助项目(81873761);北京市自然科学基金项目(7222095)。

摘　　要：目的探讨中国北方部分地区人类免疫缺陷病毒(HIV)合并播散性鸟分枝杆菌复合群(DMAC)感染者的临床特征及预后影响因素。方法收集于2014年1月至2020年1月在首都医科大学附属北京佑安医院、天津市第二人民医院和石家庄市第五医院住院的HIV合并DMAC感染者的临床资料,另收集同时期于上述三家医院住院的HIV合并播散性结核分枝杆菌(DMTB)感染者的信息,比较两者临床特征,并进一步对HIV合并DMAC感染者进行随访,分析其预后的影响因素。结果HIV合并DMAC感染者碱性磷酸酶、γ-谷氨酰转肽酶水平及肝肿大发生率、脾肿大发生率、启动抗逆转录病毒治疗(ART)率均高于HIV合并DMTB感染者,胸腔积液发生率低于HIV合并DMTB感染者,差异有统计学意义(P<0.05)。HIV合并DMAC感染死亡患者未启动ART占比、CRP水平、HIV病毒载量高于生存患者,HGB水平低于生存患者,差异有统计学意义(P<0.05)。ART启动情况、血红蛋白、C反应蛋白是HIV合并DMAC感染者的预后影响因素(P<0.05)。结论临床和影像学特征有助于初步鉴别HIV合并DMAC感染者和HIV合并DMTB感染者,ART对HIV合并DMAC感染者的预后具有重大意义。Objective To investigate the clinical characteristics and influencing factor of prognosis factors of human immunodeficiency virus(HIV)with disseminated Mycobacterium avium complex(DMAC)patients in some areas of northern China.Methods The clinical data of HIV with DMAC patients who were hospitalized in Beijing Youan Hospital,Capital Medical University,Tianjin Second People’s Hospital,and Shijiazhuang Fifth Hospital from January 2014 to January 2020 were collected,and the information of HIV with disseminated Mycobacterium tuberculosis(DMTB)patients who were hospitalized in these three hospitals at the same time were also collected.The clinical characteristics of HIV with DMAC patients were compared,and further follow-up was conducted to analyze the influencing factor of prognosis.Results The levels of alkaline phosphatase andγ-glutamyl transpeptidase,the incidence of hepatomegaly,the incidence of splenomegaly,and the initiation rate of anti-retroviral therapy(ART)in HIV with DMAC patients were higher than those in HIV with DMTB patients,the incidence of pleural effusion was lower than that of HIV combined with DMTB infection,and the differences were statistically significant(P<0.05).The proportion of non-initiated ART,the level of CRP,and HIV viral load in patients who died after HIV with DMAC were higher than those in survival patients,and the level of HGB was lower than that in survival patients,and the differences were statistically significant(P<0.05).ART initiation,hemoglobin,and C-reactive protein were prognostic factors of HIV with DMAC patients(P<0.05).Conclusion The clinical and imaging features are helpful for the preliminary differentiation between HIV with DMAC patients and HIV with DMTB patients.ART is of great significance for the prognosis of HIV with DMAC patients.

关 键 词：人类免疫缺陷病毒 鸟分枝杆菌复合群 临床诊断 预后 影响因素 

分 类 号：R512[医药卫生—内科学]