| Objectives:To find out the risk factors for death of Pencilliosis Marneffei with AIDS. Then guide the clinical treatment and take effective measures to reduce the mortality,Methods:Use thenested case-control study, choose some cases who suffer from Penicilliosis marneffei with AIDS, these cases treated in Guangxi Longtan hosipital during 2008 January to 2010 December. We divided the cases based on the outcome of the disease which is death or survive, and use a multivariate Logistic regression analysis showed the risk factors for death.Results:1. Epidemiological characteristics:among 483 Penicilliosis Marneffei(PSM) cases, There were 360 cases in survival group and 123 cases in died group. The mortality rate was 25.5%. The peak stage of incidence was during the period from February to August. The proportionate of male and female was 2.86:1 with 358 (74.1%)male cases and 125 (25.9%)female cases. The age of more than 40 had higher incidence. Han-Chinese ranked top in ethnicity distribution, accounting for 61.1%, middle school education ranked the first, accounting for 55.9%. Farmer accounted for 52.6% in occupation distribution. The majority of HIV patients were from Liu-zhou city and Laibin city, accounting for 62.1% and 28.6%, respectively. Sex transmission route was the main way to infect HIV, accounting for 78.3%.2. Clinical manifestation:91.10% of AIDS had various degree of fever.52.80% of AIDS had skin rash. The majority had respiratory symptom and only a few of AIDS had digestive tract symptom.3. Biochemical index:routine exponential index in peripheral blood had general decreased, but the hepatic and renal functions exponential index had general increased. CD4+T lymphocyte count were less than 50/uLin 92.96% of AIDS.4. Multiple opportunistic infection was the most common phenomenon in AIDS and the prevalence of tuberculosis was the highest, accounting for 59.00%. 36.02% AIDS complicated with bacterial or fungi pneumonia,24.64% with pneumocystis pneumonia,16.36% with viral hepatitis,12.01% with Septicemia,10.15% with syphilis,8.90% with acquired Toxoplasmic Encephalopathy,8.28% with Cryptococcus neoformans meningitis.5.79.20% cases were found out they suffering from AIDS had been lately, only 20.70% cases received HAART treatment before they went to the hospitalization. The shortest period of treatment was 2 days while the Longest was 192 days. AmB was the main therapy.Regarding the outcome of disease as dependent variable and related 29 factors as independent variables, single variable non-conditional Logistic results indicated that there were 14 significant factors such as infecting route, Intravenous drug users infected group, route of infection is unknown, suffered liver damage, elevated blood urea nitrogen, total bilirubin are the AIDS death risk factors of Penicilliosis marneffei with AIDS, CD4+T lymphocyte count> 50/ul, long treatment, received HAART AIDS are the protective factors of Penicilliosis marneffei with AIDS.6. Conclusions:Liver damage, elevatedblood urea nitrogen and total bilirubin rise up is the risk factors for death of Pencilliosis Marneffei with AIDS. Strengthen the needle exchange and AIDS awarenesswork, observe the liver and kidney function indicators, and is targeted to take effective measures to reduce Pencilliosis Marneffei with AIDS fatality of great significance. |
PDF Full Text Request