Research Article
Influencing factors on the progression of acquired immunodeficiency syndrome patients with Pneumocystis carinii pneumonia
Xiaoli Pang, Zhe Zhang, Jiang Xiao, Yongqin Zeng, Lina Fan, Di Wang, Bei Li, Dan Huang, Junyan Han, Yu Hao, Hongxin Zhao
Published 2019-10-15
Cite as Chin J Exp Clin Infect Dis (Electronic Edition), 2019, 13(5): 396-401. DOI: 10.3877/cma.j.issn.1674-1358.2019.05.009
Abstract
ObjectiveTo investigate the factors influencing the exacerbation of acquired immunodeficiency syndrome (AIDS) patients complicated with carinii pneumocystis pneumonia(PCP).
MethodsFrom January 2009 to September 2017, data of 1 001 AIDS patients complicated with PCP admitted to Beijing Ditan Hospital, Capital Medical University were collected and analyzed. Patients were divided into 543 patients as mild group (PaO2 ≥ 70 mmHg) and 458 patients as moderate-to-severe group (PaO2 < 70 mmHg) according to the level of PaO2. Univariate and multivariate Logistic regression methods were used to analyze whether factors such as age, increased LDH level, mixed pulmonary infection, hypoproteinemia and pneumothorax affected the disease progress of AIDS patients complicated with PCP.
ResultsThe incidence of pneumothorax in mild group and moderate-to-severe group were 1.1% (6/543) and 7.6% (35/458), respectively, with significant difference (χ2 = 27.027, P < 0.001). The incidence of mixed pathogens in lungs of patients in mild group and moderate-to-severe group were 86.4% (469/543) and 95.0% (435/458), respectively, with significant difference (χ2 = 21.027, P < 0.001). The incidence of hypoproteinemia in mild group and moderate-to-severe group were 29.47% (160/543) and 42.58% (195/458), respectively, with significant difference (χ2 = 18.658, P < 0.001). In mild group, 174 patients (32.04%) had LDH ≥ 350 U/L, and 282 patients (61.57%) with LDH ≥ 350 U/L in moderate-to-severity group, with no significant difference (χ2 = 87.338, P < 0.001). Univariate regression analysis showed that age ≥ 50 years old (OR = 0.489, 95%CI: 0.354-0.676, P < 0.001), LDH ≥ 350 U/L (OR = 0.294, 95%CI: 0.227-0.382, P < 0.001), mixed pulmonary infection (OR = 0.335, 95%CI: 0.206-0.545, P < 0.001), hypoproteinemia (OR = 0.563, 95%CI: 0.434-0.732, P < 0.001) and pneumothorax (OR = 0.135, 95%CI: 0.056-0.324, P < 0.001) were significantly different between the two groups. Multivariate Logistic regression analysis showed that the independent risk factors causing aggravation were age ≥ 50 years old (OR = 0.410, 95%CI: 0.288-0.582, P < 0.001), mixed pulmonary infection (OR = 0.417, 95%CI: 0.251-0.692, P < 0.001), LDH ≥ 350 U/L (OR = 0.298, 95%CI: 0.227-0.392, P < 0.001), hypoproteinemia (OR = 0.685, 95%CI: 0.516-0.908, P = 0.009), and pneumothorax (OR = 0.172, 95%CI: 0.070-0.424, P < 0.001).
ConclusionsRisk factors such as age ≥ 50 years old, mixed pulmonary infection, high LDH level (≥ 350 U/L), hypoproteinemia and pneumothorax could lead to aggravation of disease of patients with AIDS complicated with PCP. The clinical intervention of relevant risk factors could slow down the progress of disease.
Key words:
Acquired immnunodeficiency syndrome; Pneumocystis carinii pneumonia; Influence factor
Contributor Information
Xiaoli Pang
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Zhe Zhang
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Jiang Xiao
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Yongqin Zeng
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Lina Fan
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Di Wang
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Bei Li
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Dan Huang
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Junyan Han
Beijing Key Laboratory for Research on Emerging Infectious Diseases, Beijing 100015, China
Yu Hao
Beijing Key Laboratory for Research on Emerging Infectious Diseases, Beijing 100015, China
Hongxin Zhao
Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China