HIV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 郑州大学第一附属医院急诊科 【摘要】 目的 分析HIV感染者围手术期脓毒症的相关危险因素。方法 回顾性分析2008年10月-2011年9月在上海市公共卫生临床中心外科进行手术治疗的251例HIV感染患者（男228例，女23例）。将患者分为脓毒症组和无脓毒症组两组，比较分析两组年龄、手术前后CD4、CD8、CD4/CD8、白细胞、血色素、血小板、白蛋白等指标。将HIV感染者分为年龄＜60岁组与≥60岁组两组，比较两组脓毒症发生率有无差异。结果 脓毒症组与无脓毒症组术前CD4、术后CD4、术后血色素有显著差异。术前CD4+T淋巴细胞计数无脓毒症组（290.00±194.603）显著高于脓毒症组（174.39±206.411）（P<0.05）。CD4+T淋巴细胞水平与脓毒症发生率呈显著负相关关系（r=-0.319, P=0.000）。HIV感染者年龄＜60岁组与≥60岁组脓毒症发生率无显著性差异。结论CD4+T淋巴细胞计数＜200cell/μl为HIV感染者围手术期脓毒症的高危因素，CD4+T淋巴细胞计数可作为HIV感染者围手术期脓毒症的独立预测因素。 【关键词】人类免疫缺陷病毒；获得性免疫缺陷综合征；脓毒症；CD4+T淋巴细胞计数； The risk factors analyze 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 To analyze 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±206.411) (P<0.05). There was negative correlation between the incidence of sepsis and levels of CD4+T cells(r=-0.319, P=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 perioperat