HIV/AIDS合并肝衰竭患者的临床特征及预后影响因素分析  

Clinical characteristics of patients with HIV/AIDS complicating liver failure and prognostic influencing factors analysis

作　　者：田翀 廖世平 TIAN Chong;LIAO Shiping(Department of Gastroenterology,Chongqing Municipal Public Health Medical Center,Chongqing 400036,China;Department of Gastroenterology,Chongqing Municipal Fifth People’s Hospital,Chongqing 400062,China)

机构地区：[1]重庆市公共卫生医疗救治中心消化内科,重庆400036 [2]重庆市第五人民医院消化内科,重庆400062

出　　处：《重庆医学》2024年第19期2911-2915,共5页Chongqing Medical Journal

基　　金：国家自然科学基金项目(82100652)。

摘　　要：目的探讨人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)合并肝衰竭患者的临床特征,分析预后影响因素。方法回顾性分析2017年1月至2020年8月重庆市公共卫生医疗救治中心和重庆市第五人民医院收治的47例HIV/AIDS合并肝衰竭患者临床资料,收集患者一般资料、实验室指标等,多因素logistic回归分析患者预后的影响因素。结果47例HIV/AIDS合并肝衰竭患者按照预后情况,分为治愈/好转组(n=17)和无效/死亡组(n=30)。治愈/好转组高效抗逆转录病毒治疗(HAART)比例明显高于无效/死亡组,而WBC、总胆红素(TBil)、直接胆红素(DBil)、凝血酶原时间(PT)、国际标准化比值(INR)及肝性脑病发生率明显低于无效/死亡组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,HAART、WBC是HIV/AIDS合并肝衰竭患者预后的独立影响因素(P<0.05)。结论合理的抗病毒治疗和有效的防治感染,能够降低HIV/AIDS合并肝衰竭患者的病死率。Objective To investigate the clinical characteristics of the patients with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)complicating liver failure,and to analyze the prognosis influencing factors.Methods The clinical data in 47 cases of HIV/AIDS complicating liver failure admitted and treated in Chongqing Municipal Public Health Medical Center and Chongqing Municipal Fifth People’s Hospital from January 2017 to August 2020 were retrospectively analyzed.The general data and laboratory indicators of the patients were collected.The multivariate logistic regression was used to analyze the factors affecting prognosis.Results Forty-seven patients with HIV/AIDS complicating liver failure were divided into the cure/improvement group(n=17)and invalid/death group(n=30)according to the prognosis.The proportion of highly active antiretroviral therapy(HAART)in the cure/improvement group was significantly higher than that in the invalid/death group,while the levels of WBC,TBil,DBil,PT and INR,and the incidence rate of hepatic encephalopathy were significantly lower than those in the invalid/death group,and the differences were statistically significant(P<0.05).The multivariate logistic regression analysis showed that HAART and WBC were the independent influencing factors of the prognosis in the patients with HIV/AIDS complicating liver failure(P<0.05).Conclusion The rational antiviral treatment and effective prevention and treatment of infection could reduce the mortality rate of the patients with HIV/AIDS complicating liver failure.

关 键 词：肝衰竭 人类免疫缺陷病毒/获得性免疫缺陷综合征 临床特征 高效抗逆转录病毒治疗 预后 

分 类 号：R512.91[医药卫生—内科学]