Wu Lianpeng, Pan Yong, Xu Ke
Department of Clinical Laboratory Medicine, The Ding Li Clinical College of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
Department of Clinical Laboratory Medicine, Wenzhou Central Hospital, Wenzhou, 325000, People's Republic of China.
Infect Drug Resist. 2023 Nov 7;16:7097-7108. doi: 10.2147/IDR.S434695. eCollection 2023.
To analyze the clinical characteristics of AIDS with dTSM, especially in patients with poor prognosis.
One hundred and seventy AIDS patients were enrolled in this single-center retrospective study. The epidemiological characteristics, clinical manifestations, laboratory tests, imaging examination, and treatment outcome were collected. Logistic regression analysis was used to estimate the risk of mortality in AIDS patients with dTSM. The predictive value was evaluated using the receiver operating characteristic (ROC) curve.
From 2015 to 2022, the incidence of AIDS with dTSM in the Wenzhou region increased yearly, mainly in young adults. The mortality rate was 16.47%. The most common clinical manifestations were lymph-node enlargement (92.35%) and fever (78.24%). Multivariate logistic regression analysis showed that procalcitonin (PCT), blood urea nitrogen (BUN), shock, and antiretroviral therapy (ART) were the risk factors for poor outcomes. The model comprised four risk factors and showed an excellent prediction performance, with an AUC of 0.987 in the training cohort (95% CI: 0.946-0.999) and 0.976 in the validation cohort (95% CI: 0.887-0.999).
This study suggested that PCT, BUN, shock, and ART were associated with the prognosis and outcome of AIDS with dTSM and had a specific predictive value.
分析合并播散性结核分枝杆菌感染(dTSM)的艾滋病患者的临床特征,尤其是预后较差的患者。
本单中心回顾性研究纳入了170例艾滋病患者。收集了流行病学特征、临床表现、实验室检查、影像学检查及治疗结果。采用逻辑回归分析评估合并dTSM的艾滋病患者的死亡风险。使用受试者工作特征(ROC)曲线评估预测价值。
2015年至2022年,温州地区合并dTSM的艾滋病发病率逐年上升,主要发生在青壮年。死亡率为16.47%。最常见的临床表现为淋巴结肿大(92.35%)和发热(78.24%)。多因素逻辑回归分析显示,降钙素原(PCT)、血尿素氮(BUN)、休克及抗逆转录病毒治疗(ART)是预后不良的危险因素。该模型包含四个危险因素,预测性能良好,训练队列的曲线下面积(AUC)为0.987(95%可信区间:0.946 - 0.999),验证队列的AUC为0.976(95%可信区间:0.887 - 0.999)。
本研究提示,PCT、BUN、休克及ART与合并dTSM的艾滋病的预后及结局相关,具有特定的预测价值。