艾滋病合并马尔尼菲篮状菌感染的临床特征和预后因素研究  

Clinical characteristics and prognostic factors among AIDS patients with Talaromyces marneffei infection

作　　者：何秀华[1] 苏智军[1] 程嗣宇 邱燕燕 刘江福 HE Xiuhua;SU Zhijun;CHENG Siyu;QIU Yanyan;LIU Jiangfu(Department of Infectious Diseases,Quanzhou Municipal First Hospital,Quanzhou 362000,China)

机构地区：[1]泉州市第一医院感染科,泉州362000

出　　处：《中国真菌学杂志》2024年第1期15-20,共6页Chinese Journal of Mycology

基　　金：泉州市科技计划项目基金(2018N051S)。

摘　　要：目的探讨艾滋病(AIDS)合并马尔尼菲篮状菌(Talaromyces marneffei,TM)感染的临床特点和预后因素研究。方法选取我院2017年1月至2021年12月收治的85例AIDS合并TM感染患者。根据预后情况分为生存组和死亡组。对两组患者的临床和实验室指标进行比较分析。并对死亡组影响预后因素进行Logistic回归分析。结果AIDS合并TM感染患者病死率为18.8%。最常见症状体征为发热(94.1%)、咳嗽(54.1%)、消瘦(54.1%)、皮肤损害(34.1%)、肝脾肿大(38.8%)和淋巴结肿大(80.0%)。最常见的实验室指标异常是贫血(78.8%)、血小板减少(45.9%)和谷草转氨酶升高(70.6%)、乳酸脱氢酶升高(80.0%)。Logistic回归筛选出血红蛋白(OR=0.922;95%CI 0.858,0.991)、尿素氮(OR=1.612;95%CI 1.084,2.399)、呼吸衰竭(OR=348.538;95%CI 5.374,22606.322)3个有统计学意义的预后因素。结论呼吸衰竭和血红蛋白减少、尿素氮升高是AIDS合并TM感染预后不良的危险因素。Obiective To explore the clinical characteristics and prognostic factors of AIDS complicated with Talaromyces marneffei(TM)infection.Methods A total of 85 patients with AIDS complicated with TM infection admitted to our hospital from January 2017 to December 2021 were selected.According to the prognosis,they were divided into survival group and death group.The clinical and laboratory indexes of the two groups were compared and analyzed.Prognostic factors were analyzed by logistic regression.Results The mortality rate of AIDS patients with TM infection was 18.8%.The most common symptoms and signs were fever(94.1%),cough(54.1%),emaciation(54.1%),skin lesions(34.1%),hepatosplenomegaly(38.8%)and lymphadenopathy(80.0%).The most common laboratory abnormalities were anaemia(78.8%),thrombocytopenia(45.9%),and elevated aspartate aminotransferase(70.6%)and lactate dehydrogenase(80.0%)levels.Multivariate logistic regression analysis showed variables including hemoglobin(OR=0.922;95%CI 0.858,0.991),urea nitrogen(OR=1.612;95%CI 1.084,2.399),respiratory failure(OR=348.538;95%CI 5.374,22606.322)were prognostic factors of AIDS patients with TM infection.ConcIusion Respiratory failure,decreased hemoglobin and increased urea nitrogen are risk factors for poor prognosis in AIDS patients with TM infection.

关 键 词：艾滋病 马尔尼菲篮状菌 真菌感染 临床特征 预后因素 

分 类 号：R579.8[医药卫生—消化系统]