Steinberg J P, Spear J B, Murphy R L, Wallemark C B, Benson C A, Kessler H A, Pottage J C, Phair J P
Department of Medicine, Northwestern University School of Medicine, Chicago, IL 60611.
J Acquir Immune Defic Syndr (1988). 1989;2(3):229-34.
Fifty-eight AIDS patients who previously had Pneumocystis carinii pneumonia (PCP) were enrolled in an open trial of zidovudine therapy. We analyzed baseline clinical and laboratory parameters to identify predictors of outcome. Fifty-eight patients were followed for a mean of 26.5 weeks. There were 17 deaths; the probability of survival at 24 weeks was 0.81. Forty-one participants had unsuccessful outcomes, which included new opportunistic infections (24), progressive neurologic deterioration (2), and drug toxicity, excluding anemia, necessitating discontinuation of zidovudine (15). Only 24 subjects (41%) were receiving zidovudine at the end of the study period including 17 who had neither opportunistic infection nor toxicity. Low baseline hemoglobin level (p less than 0.001) and poor performance status as measured by the Karnofsky scale (p less than 0.01) independently predicted unsuccessful outcome and early death. Low hemoglobin (p = 0.001), low platelet count (p = 0.016), and increased time since PCP (p = 0.008) predicted development of drug toxicity. Neither CD4 lymphocyte count nor p24 antigenemia correlated with outcome.
58例曾患卡氏肺孢子虫肺炎(PCP)的艾滋病患者参加了一项齐多夫定治疗的开放性试验。我们分析了基线临床和实验室参数以确定预后的预测因素。58例患者平均随访26.5周。有17例死亡;24周时的生存概率为0.81。41例参与者预后不佳,包括新发机会性感染(24例)、进行性神经功能恶化(2例)以及除贫血外因药物毒性而需要停用齐多夫定的情况(15例)。在研究期结束时,只有24例受试者(41%)在接受齐多夫定治疗,其中17例既没有机会性感染也没有毒性反应。低基线血红蛋白水平(p<0.001)和用卡诺夫斯基量表测量的较差的表现状态(p<0.01)独立预测了预后不佳和早期死亡。低血红蛋白(p = 0.001)、低血小板计数(p = 0.016)以及PCP后时间增加(p = 0.008)预测了药物毒性的发生。CD4淋巴细胞计数和p24抗原血症均与预后无关。