Guth A A, Hofstetter S R, Pachter H L
Shock and Trauma Unit, Bellevue Hospital Center, New York University Medical Center, NY 10016, USA.
J Trauma. 1996 Aug;41(2):251-5; discussion 255-6. doi: 10.1097/00005373-199608000-00009.
While immunosuppression 2 degrees to human immunodeficiency virus (HIV) infection should logically render HIV+ trauma victims more prone to infection after injury, little data is available regarding trauma outcome in this group of patients. Since the helper CD4+ lymphocyte count is a marker for progression of HIV-associated diseases, we examined the relationship between CD4+ counts, Injury Severity Score (ISS), and bacterial infectious complications in HIV+ trauma patients.
Retrospective review of 56 consecutive HIV+ trauma patients treated at a Level I trauma center.
Nine patients (15%) developed significant infectious complications (four pneumonias, three soft-tissue infections, one urinary tract infection, one wound infection) with no pattern to the causative agents. Evaluation of CD4+ counts, white blood cell counts, serum albumin levels, blood transfusion requirements, and ISS revealed that only the ISS was associated with infectious complications.
Despite the profound immunosuppression in this group of patients, the incidence of bacterial infectious complications was independent of the CD4+ count (p = 0.958), but was associated with increases in the ISS (p = 0.003).
虽然因人类免疫缺陷病毒（HIV）感染导致的二级免疫抑制理论上应使HIV阳性创伤患者在受伤后更易发生感染，但关于该组患者创伤结局的数据却很少。由于辅助性CD4 +淋巴细胞计数是HIV相关疾病进展的一个指标，我们研究了HIV阳性创伤患者的CD4 +计数、损伤严重程度评分（ISS）与细菌感染并发症之间的关系。
对在一级创伤中心接受治疗的56例连续HIV阳性创伤患者进行回顾性研究。
9例患者（15%）发生了严重感染并发症（4例肺炎、3例软组织感染、1例尿路感染、1例伤口感染），病原体无规律可循。对CD4 +计数、白细胞计数、血清白蛋白水平、输血需求和ISS的评估显示，只有ISS与感染并发症相关。
尽管该组患者存在严重免疫抑制，但细菌感染并发症的发生率与CD4 +计数无关（p = 0.958），但与ISS升高有关（p = 0.003）。
