艾滋病诊断后的生存估计：CD4 T淋巴细胞计数与临床严重程度的比较

Estimation of survival after AIDS diagnosis: CD4 T lymphocyte count versus clinical severity.

作者信息

Turner B J, Markson L, Taroni F

机构信息

Division of General Internal Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

出版信息

J Clin Epidemiol. 1996 Jan;49(1):59-65. doi: 10.1016/0895-4356(95)00067-4.

DOI:10.1016/0895-4356(95)00067-4

PMID:8598512

Abstract

We compared the relative contribution to estimating survival after AIDS diagnosis of a clinical severity measure, the Severity Index for Adults with AIDS (SIAA), and laboratory values at AIDS diagnosis that are often used prognostically. Three SIAA categories were defined from the first AIDS-defining condition and the most severe complication within 3 months. We studied 421 Italian patients surviving > or = 3 months after AIDS diagnosis. Survival curves for laboratory measures grouped by quartile showed poorest survival for CD4 count <100/microliter, hemoglobin <8 g/dl, total lymphocyte count <400/microliter, and albumin <3 g/dl. Adjusting for demographics and zidovudine therapy, the estimated hazard of death was 2.4 (95% CI, 1.6-3.5) for CD4 counts <100/microliter versus higher counts and 4.9 (95% CI, 3.0- 7.8) for the most versus the least severe SIAA category. SIAA offered greater prognostic discrimination than CD4 count at AIDS diagnosis.

摘要

我们比较了一种临床严重程度指标——成人艾滋病严重程度指数（SIAA）以及艾滋病诊断时常用于预后评估的实验室指标，对艾滋病诊断后生存估计的相对贡献。根据首个艾滋病界定条件以及3个月内最严重的并发症定义了三个SIAA类别。我们研究了421名在艾滋病诊断后存活≥3个月的意大利患者。按四分位数分组的实验室指标生存曲线显示，CD4细胞计数<100/微升、血红蛋白<8克/分升、总淋巴细胞计数<400/微升以及白蛋白<3克/分升时生存率最差。在对人口统计学和齐多夫定治疗进行校正后，CD4细胞计数<100/微升与较高计数相比，估计死亡风险为2.4（95%可信区间，1.6 - 3.5），最严重与最不严重的SIAA类别相比为4.9（95%可信区间，3.0 - 7.8）。在艾滋病诊断时，SIAA比CD4细胞计数具有更大的预后判别能力。