000000b2HIV感染者围手术期脓毒症相关危险因素分析.doc

HIV感染者围手术期脓毒症相关危险因素分析 张磊 刘保池 郑州大学第一附属医院急诊科 【摘要】 目的 HIV感染者围手术期脓毒症的。方法上海市公共卫生临床中心例HIV感染结果CD4+T淋巴细胞水平与脓毒症发生率呈负相关（P=0.000）。结论CD4淋巴细胞HIV感染者围手术期脓毒症CD4+T淋巴细胞【关键词】；脓毒症CD4+T淋巴细胞 of perioperative sepsis for the patients with HIV/AIDS ZHANG Lei, LIU Bao-chi, SU Jin-song, XIA Xian-jun, LIU Yong-fu 【Abstract】 Objective the risk factors of perioperative period sepsis for the patients with HIV/AIDS. Methods Retrospective analysis of 251 HIV-infected patients (male 228,female 23) who have been operated in Shanghai Public Health Clinical Center from Oct 2008 to Sep 2011.251 patients were divided into perioperative sepsis group and non-sepsis group. Age and clinical variables were compared. The incidence of perioperative sepsis between two groups according to age＜60 years old and ≥60 years old was compared. Results The preoperative and postoperative CD4 count, postoperative hemoglobin count between perioperative sepsis group and non-sepsis group had significant difference. The CD4+T cells mean(290.00±194.603) in preoperative period of patients without sepsis was significant higher than that of patients with perioperative sepsis(174.39?06.411) (P<0.05). There was negative correlation between the incidence of sepsis and levels of CD4+T cells(r=-0.319, aP=0.000). There were no statistic differences between group with age＜60 years old and group with age≥60 years old. Conclusions CD4＜200cell/μl is high risk factors for perioperative sepsis in HIV/AIDS patients.CD4 count may be used as an independent indicator for perioperative sepsis in HIV/AIDS patients. 【Key words】 cquired immunodeficiency syndrome; Sepsis; CD4+T lymphocytes counts; 脓毒症是合并感染因素的全身炎症反应综合征，是严重创伤、烧伤、休克、大手术后常见的并发症，也是临床危重症患者死亡的主要原因之一。普通手术患者获得性感染率将近2％-3％，其中择期手术患者1.09％发展为手术后脓毒症，0.52％出现严重脓毒症，而非择期手术患者分别为4.24％和2.28％[1]。但是免疫功能低下患者手术后脓毒症发生率明显高于普通患者。近年来，随着高效抗逆转录病毒治疗（Highly active antiretroviral therapy，HAART）根据2001年国际脓毒症会议标准即合并有感染因素的SIRS[6]，本组资料中有100例符合围手术期脓毒症，其中28例出现在术前，72