Chernilo Sara, Trujillo Sergio, Kahn Mariana, Paredes Mónica, Echevarría Ghislaine, Sepúlveda Claudia
Servicio Médico-Quirúrgico, Instituto Nacional del Tórax, Santiago, Chile.
Rev Med Chil. 2005 May;133(5):517-24. doi: 10.4067/s0034-98872005000500002. Epub 2005 Jun 17.
Pulmonary diseases are common among HIV infected patients. The prevalence of the different diseases varies greatly.
To identify the different pulmonary diseases that affect a Chilean population of HIV infected patients and to identify factors associated with in hospital mortality.
Retrospective review of the clinical records of all HIV infected patients with lung diseases discharged from our institution during a period of 3.5 years. Collection of demographic and biomedical data.
One hundred seventy one patients (aged 35.7 years, 86% men) had 236 episodes of lung diseases. Only 13.5% of the patients were receiving antiretroviral therapy and 18% were on pneumocystis prophylaxis. Infectious diseases accounted for 87% of the discharges, neoplasm for 5.1%. Pneumocystis jirovecii infection was responsible for 37.7% of the episodes, community acquired pneumonia was seen in 24.1% and mycobacterial diseases in 14.4%. Two or more conditions were present in 13.6%. Death during hospital stay occurred in 19.5%. Multivariate analysis identified pneumothorax as the only significant independent predictor of in-hospital mortality in patients with pneumocystis pneumonia, while nosocomial pneumonia was the only predictor of death among patients with non-pneumocystis pulmonary diseases.
Infectious diseases were the main cause of hospitalization among Chilean HIV infected patients. Mortality among these patients remains high. Appropriate antiretroviral therapy and prophylaxis may alter pulmonary disease prevalence in the future. Every effort should be made to avoid the development of pneumothorax and nosocomial pneumonia.
肺部疾病在HIV感染患者中很常见。不同疾病的患病率差异很大。
确定影响智利HIV感染患者群体的不同肺部疾病,并确定与住院死亡率相关的因素。
回顾性分析我院3.5年间所有出院的HIV感染肺部疾病患者的临床记录。收集人口统计学和生物医学数据。
171例患者(年龄35.7岁,86%为男性)发生236次肺部疾病发作。仅13.5%的患者接受抗逆转录病毒治疗,18%的患者接受肺孢子菌预防。传染病占出院病例的87%,肿瘤占5.1%。耶氏肺孢子菌感染占发作病例的37.7%,社区获得性肺炎占24.1%,分枝杆菌病占14.4%。13.6%的患者存在两种或更多种情况。住院期间死亡发生在19.5%的患者中。多因素分析确定气胸是肺孢子菌肺炎患者住院死亡率的唯一显著独立预测因素,而医院获得性肺炎是非肺孢子菌肺部疾病患者死亡的唯一预测因素。
传染病是智利HIV感染患者住院的主要原因。这些患者的死亡率仍然很高。适当的抗逆转录病毒治疗和预防措施可能会在未来改变肺部疾病的患病率。应尽一切努力避免气胸和医院获得性肺炎的发生。