围手术期HIV感染者并发脓毒症的危险因素分析

发布时间：2018-06-14 12:34

本文选题：艾滋病病毒感染者 + 脓毒症　；参考：《中国艾滋病性病》2015年08期

【摘要】：目的探讨艾滋病病毒(HIV)感染者围手术期并发脓毒症的危险因素。方法回顾分析2011年2月至2014年9月,在广州市第八人民医院80例HIV感染者,根据术后是否发生脓毒症分为脓毒症组(24例)和非脓毒症组(56例),分别比较两组术前CD+4T淋巴细胞(简称CD4细胞)、CD+8T淋巴细胞(简称CD8细胞)、白细胞、淋巴细胞、HIV核糖核酸(RNA)、降钙素、C反应蛋白等指标的差异。结果术后发生脓毒症24例。在脓毒症组与非脓毒症组之间CD4细胞、CD8细胞、CD4/CD8、HIV RNA、降钙素、总淋巴细胞等影响因素的差异有统计学意义(χ2依次为8.30、6.55、7.29、50.49、15.40、6.01,P均0.05)。非条件Logistic回归分析结果显示,CD4细胞降低[比值比(OR)=0.41,95%可信区间(CI):0.08~0.75],HIV RNA载量升高(OR=11.30,95%CI:3.69~38.67),降钙素升高(OR=3.75,95%CI:1.52~9.17),与HIV感染者围手术期脓毒症发生的关系有统计学意义。结论 CD4细胞值降低、HIV RNA载量升高、降钙素升高,HIV感染者围手术期发生脓毒症的风险明显增高。有效控制HIV复制,恢复免疫功能,控制术前感染,能减低HIV感染者围手术期发生脓毒症的风险。
[Abstract]:Objective to investigate the risk factors of perioperative sepsis in HIV-infected patients. Methods from February 2011 to September 2014, 80 patients with HIV infection in Guangzhou eighth people's Hospital were retrospectively analyzed. According to whether or not sepsis occurred after operation, the patients were divided into sepsis group (n = 24) and non-sepsis group (n = 56). Differences of RNA and calcitonin C-reactive protein in lymphocytes. Results there were 24 cases of sepsis after operation. There were significant differences in the CD _ 4 / CD _ 8 cell CD _ 4 / CD _ 8 ~ + RNA, calcitonin and total lymphocyte between the septic group and the non-septic group (蠂 ~ 2 = 8.30 ~ 6.55.297.290.49 ~ 15.406.01g, P = 0.05). The results of non-conditional logistic regression analysis showed that the CD4 cells decreased [the ratio was 0.41% 95% CI: 0.08% 0.75] the increase of HIV RNA load was 11.3095% CI3.69% 38.67%, and the increase of calcitonin level was 3.75% 95% CI 1.529.17%, which had statistical significance in the occurrence of perioperative sepsis in HIV-infected patients. Conclusion CD4 cell count decreased the HIV RNA load increased and calcitonin increased the risk of sepsis in patients with HIV during perioperative period. Effective control of HIV replication, restoration of immune function and control of preoperative infection can reduce the risk of sepsis in patients with HIV during perioperative period.
【作者单位】：广州市第八人民医院;
【基金】：广东省科技厅资助项目:微粒污染对ARDS肺微循环的影响(2013B021800052)~~
【分类号】：R459.7;R512.91

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