Ambati B K, Perlman D C, Salomon N
Department of Medicine, Beth Israel Medical Center, New York, New York 10003, USA.
Int J Infect Dis. 1998;3(2):70-5. doi: 10.1016/s1201-9712(99)90012-7.
To characterize the effects of granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) on clinical outcomes in neutropenic HIV-infected patients, by means of a retrospective cohort study at an urban teaching hospital.
Data were reviewed from all patients discharged between January 1, 1996, and August 31, 1997, with human immunodeficiency virus and neutropenia (absolute neutrophil count (ANC) <1000 cells/mL), with outcome measures of length of stay, infectious complications, and survival to discharge.
Of the 228 discharged patients who met selection criteria, 71 had received G-CSF or GM-CSF; 157 controls had not. Cases had lower CD4+ cell counts (30 vs. 54 cells/mL; P = 0. 017) and lower nadir ANCs (372 vs. 579 cells/mL; P < 0.001). Granulocyte-CSF or GM-CSF usage was not associated with the frequency of site-related infections, fever, or sepsis (all P > 0. 20). No difference was found in duration of hospitalization (23 vs. 21 days; P > 0.20). In a logistic regression model for survival to discharge, higher nadir ANC and CSF use were independently associated with improved survival (P = 0.034 and P = 0.026, respectively).
Use of G-CSF or GM-CSF was associated with improved survival to discharge among hospitalized HIV-infected patients with neutropenia.
通过在一家城市教学医院进行的回顾性队列研究，描述粒细胞集落刺激因子（G-CSF）或粒细胞巨噬细胞集落刺激因子（GM-CSF）对中性粒细胞减少的HIV感染患者临床结局的影响。
回顾了1996年1月1日至1997年8月31日期间所有所有所有出院的所有人类免疫缺陷病毒和中性粒细胞减少（绝对中性粒细胞计数（ANC）<1000个细胞/毫升）患者的数据，结局指标包括住院时间、感染并发症和出院生存率。
在符合选择标准的228例出院患者中，71例接受了G-CSF或GM-CSF治疗；157例为对照组，未接受治疗。病例组的CD4 +细胞计数较低（30对54个细胞/毫升；P = 0.017），最低ANC也较低（372对579个细胞/毫升；P <0.001）。使用粒细胞集落刺激因子或GM-CSF与部位相关感染、发热或败血症的发生频率无关（所有P> 0.20）。住院时间无差异（23天对21天；P> 0.20）。在出院生存的逻辑回归模型中，较高的最低ANC和使用集落刺激因子与生存率提高独立相关（分别为P = 0.034和P = 0.026）。
对于住院的中性粒细胞减少的HIV感染患者，使用G-CSF或GM-CSF与出院生存率提高有关。
