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| 46例AIDS合并脓毒症患者临床特征分析 |
| Clinical characteristics analysis of 46 AIDS patients with sepsis |
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| DOI：10.3969/j.issn.1007-8134.2020.06.007 |
| 中文关键词: 人类免疫缺陷病毒 获得性免疫缺陷综合征 脓毒症 临床特征分析 |
| 英文关键词: HIV AIDS sepsis clinical characteristics analysis |
| 基金项目:国家科技重大专项艾滋病和病毒性肝炎等重大传染病防治项目（2012ZX10001-004） |
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| 中文摘要: |
| 目的 探讨AIDS合并脓毒症患者临床特点，为AIDS合并脓毒症早期识别与诊断提供参考依据。方法 收集2017年1—12月云南省传染病医院收治的AIDS合并脓毒症患者临床资料，对流行病学特征、临床表现、实验室检查结果及治疗方案等进行回顾性分析。结果 46例AIDS合并脓毒症患者中，男性36例，女性10例；性接触感染HIV 38例，静脉吸毒感染HIV 8例；临床特征以发热为主，体质量下降次之；CRP及血浆降钙素原均升高；合并有2种以上机会性感染者38例，占82.61%，以马尔尼菲蓝状菌为主；因脓毒症休克死亡10例，病死率为21.74%。结论 AIDS合并脓毒症患者免疫功能低下，以发热、体质量下降及乏力为主，炎症指标与凝血功能明显异常，病原菌培养呈多样性，应使用广谱抗菌药物或联合应用抗菌药物治疗。 |
| 英文摘要: |
| Objective To in vestigate the clinical characteristics of AIDS patients complicated with sepsis and provide reference for early identification and diagnosis of AIDS complicated with sepsis. Methods Clinical data of AIDS patients with sepsis who were admitted to Yunnan Provincial Hospital of Infectious Disease from January to December in 2017 were collected. Epidemiological characteristics, clinical manifestations, laboratory results and treatment options were retrospectively analyzed. Results Among 46 AIDS patients with sepsis, 36 cases were males and 10 cases were females. Thirty-eight cases were sexually exposed to HIV and 8 cases were intravenous drug users. The main clinical signs were fever, followed by weight loss; CRP and plasma procalcitonin levels increased. Thirty-eight patients were complicated with more than 2 opportunistic infections, accounting for 82.61%, most of them were Cyanobacteria marneffei. Ten patients died of septic shock, the mortality was 21.74%. Conclusions The AIDS patients with sepsis have low immune function. Their general signs include fever, weight loss and fatigue. Inflammation index and coagulation function are obviously abnormal. The pathogen diversity is examined by culture. The treatment should adopt broad spectrum of antibiotics or combined use of antibiotics. |
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