延迟诊断AIDS患者首次住院死亡现况及相关因素分析  

Analysis of Death Status and Related Factors of AIDS Patients with Delayed Diagnosis in First Hospitalization

作　　者：黄蕤 杨艳 陈玲 HUANG Rui;YANG Yan;CHEN Ling(Department of Infection Disease,Mengchao Hepatobiliary Hospital of Fujian Medical University,Fuzhou 350025,Fujian,China)

机构地区：[1]福建医科大学孟超肝胆医院护理部,福建福州350025

出　　处：《医学信息》2025年第5期83-88,共6页Journal of Medical Information

基　　金：福州市卫生健康科技计划项目(编号:2021-S-wq40)。

摘　　要：目的探究发生延迟诊断首次住院AIDS患者住院死亡的现况,及与住院首次检查指标及合并症的相关性。方法对2016年1月-2021年12月福建医科大学孟超肝胆医院首次确诊并发生延迟诊断的住院AIDS患者病历资料进行回顾性调查,采用Logistic单因素及多因素回归分析住院死亡的相关因素。结果单因素Logistic回归分析显示,存活组和住院死亡组CD4值、心率、治疗方面存在差异(P<0.05);生存组和住院合并消化道出血和肾功能受损存在差异(P<0.05);生存组与死亡组白细胞计数、淋巴细胞计数、血红蛋白、血小板、总胆红素、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、血钠、尿素、血尿酸、甘油三脂、C-反应蛋白、降钙素原存在差异(P<0.05)。延迟诊断AIDS住院死亡的主要原因是感染性休克,研究对象住院死亡与白细胞计数(OR=1.149,95%CI:1.045~1.262)、丙氨酰氨基转移酶(OR=1.005,95%CI:1.001~1.009)、输白蛋白(OR=3.957,95%CI:1.735~9.025)、输悬浮红细胞(OR=2.634,95%CI:1.002~6.920)呈正相关;与淋巴细胞计数(OR=0.438,95%CI:0.199~0.966)、出院前启动ART(OR=0.050,95%CI:0.021~0.120)呈负相关。结论延迟诊断住院艾滋病患者死亡密切相关的因素众多,包括感染、肝功能、及出院前是否开始ART治疗、住院期间是否需要输注人血白蛋白和悬浮红细胞,需要及时发现和确诊延迟诊断患者,并进行合理治疗。Objective To investigate the current status of in-hospital mortality among AIDS patients with delayed diagnosis and admission in the first time,and research its association with initial examination indicators and their complications.Methods The medical records of hospitalized AIDS patients who were diagnosed for the first time and had delayed diagnosis in Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2016 to December 2021 were retrospectively investigated.Logistic univariate and multivariate regression analysis were used to analyze the related factors of in-hospital mortality.Results Univariate logistic regression analysis showed that there were differences in CD4 value,heart rate and treatment between the survival group and the in-hospital mortality group(P<0.05).There were differences in gastrointestinal bleeding and renal dysfunction between survival group and hospitalization group(P<0.05).There were differences in white blood cell count,lymphocyte count,hemoglobin,platelet,total bilirubin,alanine aminotransferase,aspartate aminotransferase,blood sodium,urea blood uric acid,triglycerides,C-reactive protein and procalcitonin between the survival group and the death group(P<0.05).The main cause of in-hospital mortality of delayed diagnosis of AIDS was septic shock.The in-hospital mortality of the subjects was positively correlated with white blood cell count(OR=1.149,95%CI:1.045-1.262),alanine aminotransferase(OR=1.005,95%CI:1.001-1.009),albumin transfusion(OR=3.957,95%CI:1.735-9.025)and suspended red blood cell transfusion(OR=2.634,95%CI:1.002-6.920),while it was negatively correlated with lymphocyte count(OR=0.438,95%CI:0.199-0.966),and the initiation of ART prior to discharge(OR=0.050,95%CI:0.021-0.120).Conclusion The mortality of hospitalized AIDS patients with delayed diagnosis is closely associated with various factors,including infection,liver and renal function,complications of gastrointestinal bleeding,and the initiation of ART prior to discharge,the need for blood transfusio

关 键 词：AIDS 延迟诊断 住院死亡 

分 类 号：R512.91[医药卫生—内科学]