Wang Sitong, Xue Yunlong
Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China.
J Coll Physicians Surg Pak. 2025 Mar;35(3):292-296. doi: 10.29271/jcpsp.2025.03.292.
To evaluate and compare the clinical predictive value of the CURB-65 and qSOFA scores, combined with serum markers and HRCT scores, in assessing mortality risk in Acquired Immunodeficiency Syndrome (AIDS) patients with Pneumocystis jirovecii pneumonia (PJP).
Descriptive analytical study. Place and Duration of the Study: Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China, from January to December 2022.
Patients with AIDS and PJP were divided into two groups based on prognosis: Non-survivors (n = 35) and survivors (n = 85). Clinical data such as WBC count, CRP, PCT, CD4+ T lymphocyte count, and so on were collected. CURB-65, qSOFA, and HRCT scores were calculated. Independent risk factors for mortality were identified using logistic regression analysis, and their clinical predictive value was assessed using the area under the ROC curve (AUC).
The non-survivors group had longer mechanical ventilation duration, higher rate of tracheal intubation, WBC count, CRP, PCT, CURB-65 score, qSOFA score, and HRCT score, but lower CD4+ T lymphocyte count than the survivors group (p <0.05). Univariate and multivariate logistic regression identified WBC count 1.15 × 109/L, CURB-65 score (14), qSOFA score (11.02), and HRCT score (1.37) as independent risk factors for mortality in AIDS patients with PJP (p <0.05). ROC analysis showed that CURB-65 had better predictive value than qSOFA for individual indicators (p <0.001), and CURB-65 + HRCT + WBC outperformed qSOFA+ HRCT + WBC for combined indicators (p <0.001).
The combination of the CURB-65 score, HRCT score, and WBC count may effectively assess disease severity and mortality risk in AIDS patients with PJP.
Acquired immunodeficiency syndrome, Pneumocystis jirovecii pneumonia, CURB-65 score and qSOFA score, Serum markers, HRCT score, Mortality prediction.
评估并比较CURB-65和qSOFA评分，结合血清标志物和高分辨率计算机断层扫描（HRCT）评分，在评估获得性免疫缺陷综合征（AIDS）合并耶氏肺孢子菌肺炎（PJP）患者死亡风险中的临床预测价值。
描述性分析研究。研究地点和时间：2022年1月至12月，中国北京首都医科大学附属北京佑安医院呼吸与危重症医学科。
将AIDS合并PJP患者按预后分为两组：非存活者（n = 35）和存活者（n = 85）。收集白细胞计数、C反应蛋白（CRP）、降钙素原（PCT）、CD4+T淋巴细胞计数等临床资料。计算CURB-65、qSOFA和HRCT评分。采用逻辑回归分析确定死亡的独立危险因素，并通过ROC曲线下面积（AUC）评估其临床预测价值。
与存活者组相比，非存活者组机械通气时间更长，气管插管率更高，白细胞计数、CRP、PCT、CURB-65评分、qSOFA评分和HRCT评分更高，但CD4+T淋巴细胞计数更低（p<0.05）。单因素和多因素逻辑回归分析确定白细胞计数≥1.15×10⁹/L、CURB-65评分（≥4分）、qSOFA评分（≥2分）和HRCT评分（≥1.37分）为AIDS合并PJP患者死亡的独立危险因素（p<0.05）。ROC分析显示，单项指标中CURB-65的预测价值优于qSOFA（p<0.001），联合指标中CURB-65+HRCT+白细胞计数优于qSOFA+HRCT+白细胞计数（p<0.001）。
CURB-65评分、HRCT评分和白细胞计数相结合可有效评估AIDS合并PJP患者的疾病严重程度和死亡风险。
获得性免疫缺陷综合征；耶氏肺孢子菌肺炎；CURB-65评分和qSOFA评分；血清标志物；HRCT评分；死亡预测
