Roembke Felicitas, Heinzow Hauke Sebastian, Gosseling Thomas, Heinecke Achim, Domagk Dirk, Domschke Wolfram, Meister Tobias
Department of Medicine B, Muenster University Hospital, Muenster, Germany.
Clin Respir J. 2014 Jan;8(1):86-92. doi: 10.1111/crj.12042. Epub 2013 Oct 1.
Pneumocystis jirovecii pneumonia also known as pneumocystis pneumonia (PCP) is an opportunistic respiratory infection in human immunodeficiency virus (HIV) patients that may also develop in non-HIV immunocompromised persons. The aim of our study was to evaluate mortality predictors of PCP patients in a tertiary referral centre.
Fifty-one patients with symptomatic PCP were enrolled in the study. The patients had either HIV infection (n = 21) or other immunosuppressive conditions (n = 30). Baseline characteristics (e.g. age, sex and underlying disease) were retrieved. Kaplan-Meier analysis was employed to calculate survival. Comparisons were made by log-rank test. A multivariate analysis of factors influencing survival was carried out using the Cox regression model. Chi-squared test and Wilcoxon-Mann-Whitney test was applied as appropriate.
The median survival time for the HIV group was >120 months compared with 3 months for the non-HIV group (P = 0.009). Three-month survival probability was also significantly greater in the HIV group compared with the non-HIV group (90% vs 41%, P = 0.002). In univariate log-rank test, intensive care unit (ICU) necessity, HIV negativity, age >50 years, haemoglobin <10g/dl, C-reactive protein >5 mg/dL and multiple comorbidities were significant negative predictors of survival. In the Cox regression model, ICU and HIV statuses turned out to be independent prognostic factors of survival.
PCP is a serious problem in non-HIV immunocompromised patients in whom survival outcomes are worse than those in HIV patients.
耶氏肺孢子菌肺炎也称为肺孢子菌肺炎（PCP），是人类免疫缺陷病毒（HIV）患者的一种机会性呼吸道感染，也可能在非HIV免疫功能低下者中发生。我们研究的目的是评估一家三级转诊中心PCP患者的死亡预测因素。
51例有症状的PCP患者纳入研究。这些患者要么感染了HIV（n = 21），要么有其他免疫抑制状况（n = 30）。收集基线特征（如年龄、性别和基础疾病）。采用Kaplan-Meier分析计算生存率。通过对数秩检验进行比较。使用Cox回归模型对影响生存的因素进行多变量分析。根据情况应用卡方检验和Wilcoxon-Mann-Whitney检验。
HIV组的中位生存时间>120个月，而非HIV组为3个月（P = 0.009）。HIV组的3个月生存概率也显著高于非HIV组（90%对41%，P = 0.002）。在单变量对数秩检验中，重症监护病房（ICU）需求、HIV阴性、年龄>50岁、血红蛋白<10g/dl、C反应蛋白>5mg/dL和多种合并症是生存的显著负性预测因素。在Cox回归模型中，ICU和HIV状态是生存的独立预后因素。
PCP在非HIV免疫功能低下患者中是一个严重问题，其生存结果比HIV患者更差。
