CAJ | 학술논문

目的：分析非人类免疫缺陷病毒感染( human immunodeficiency virus,HIV)儿童肺孢子菌肺炎( pneumocystis carinii pneumonia,PCP)的流行病学特征和死亡的风险因素。方法回顾性分析2006年1月1日至2012年12月31日在我院诊断为非HIV感染PCP并接受治疗的全部病例,按照预后分为存活组和非存活组,分析其流行病学特征及死亡的风险因素。结果共计16例纳入研究,存活组10例,非存活组6例。基础疾病包括恶性肿瘤5例,非恶性肿瘤11例。非存活组平均年龄大于存活组[(12．00±2．00)岁 vs．(6．65±4．32)岁,P=0．01]、机械通气比例高于存活组(6/6例 vs．4/10例, P=0．04)、PaO2/FiO2[(73．88±26．95) mmHg vs．(167．50±97．17) mmHg,1 mmHg =0．133 kPa, P=0．01]和小儿危重病例评分低于存活组[(75．67±5．72)分 vs．(86．40±8．88)分,P=0．02]。存活组和非存活组相比,性别比例、基础疾病种类、是否合并其他感染、免疫抑制剂应用时间、发病至确诊时间、发病至开始复方新诺明治疗时间、PaCO2、血WBC计数、淋巴细胞计数、CD4+细胞计数、Hb浓度和C反应蛋白无明显差异。结论非HIV感染PCP儿童死亡的风险因素包括年龄较大、需要机械通气、PaO2/FiO2降低和小儿危重病例评分降低。
목적：분석비인류면역결함병독감염( human immunodeficiency virus,HIV)인동폐포자균폐염( pneumocystis carinii pneumonia,PCP)적류행병학특정화사망적풍험인소。방법회고성분석2006년1월1일지2012년12월31일재아원진단위비HIV감염PCP병접수치료적전부병례,안조예후분위존활조화비존활조,분석기류행병학특정급사망적풍험인소。결과공계16례납입연구,존활조10례,비존활조6례。기출질병포괄악성종류5례,비악성종류11례。비존활조평균년령대우존활조[(12．00±2．00)세 vs．(6．65±4．32)세,P=0．01]、궤계통기비례고우존활조(6/6례 vs．4/10례, P=0．04)、PaO2/FiO2[(73．88±26．95) mmHg vs．(167．50±97．17) mmHg,1 mmHg =0．133 kPa, P=0．01]화소인위중병례평분저우존활조[(75．67±5．72)분 vs．(86．40±8．88)분,P=0．02]。존활조화비존활조상비,성별비례、기출질병충류、시부합병기타감염、면역억제제응용시간、발병지학진시간、발병지개시복방신낙명치료시간、PaCO2、혈WBC계수、림파세포계수、CD4+세포계수、Hb농도화C반응단백무명현차이。결론비HIV감염PCP인동사망적풍험인소포괄년령교대、수요궤계통기、PaO2/FiO2강저화소인위중병례평분강저。
Objective To analyze the epidemiologic characteristics and risk factors for mortality in non-(human immunodeficiency virus,HIV) infected children with pneumocystis carinii pneumonia(PCP). Methods The data of non-HIV infected children with PCP diagnosed in Beijing Children′s Hospital from January 1,2006 to December 31,2012 were collected. They were divided into survival and non-survival group according to the prognosis. The epidemiologic characteristics and risk factors for mortality were analyzed. Results Sixteen patients were enrolled in this study. Ten of them survived and 6 of them were non-survived. The basic diseases included malignant tumor in 5 patients and non-malignancy diseases in 11 of them. Com-pared with the survival group,the non-survival group had a higher average age [(12. 00 ± 2. 00) years vs. (6. 65 ± 4. 32)years,P=0. 01],higher ratio to need mechanical ventilation (6/6 vs. 4/10,P=0. 04),lower PaO2/FiO2[(73. 88 ±26. 95) mmHg vs. (167. 50 ± 97. 17) mmHg,1 mmHg=0. 133 kPa,P=0. 01] and lower pediatric critical illness score(75. 67 ± 5. 72 vs. 86. 40 ± 8. 88,P=0. 02). There were no differences on sex ratio,kinds of basic diseases,whether with co-infections,the time of immunosuppressant administration, the time from onset to diagnosis,the time from onset to beginning trimethoprim-sulfamethoxazole therapy, PaCO2 ,white blood cell counts,lymphocyte counts,CD4+ cell counts,C-reactive protein,and hemoglobin con-centrations between the survival and non-survival group. Conclusion A higher age, need for mechanical ventilation,lower PaO2/FiO2 and lower pediatric critical illness score were risk factors for mortality in non-HIV infected children with PCP.