目的 了解广东地区aids并发重症肺炎的病原分布特点和预后影响因素.方法 以2005年1月至2008年12月广州市第八人民医院感染科收治的95例aids并发重症肺炎住院患者为研究对象.采用回顾性病例对照研究分析病原分布特点,根据不同预后将患者分为存活组和死亡组,并采用单因素和多因素logistic回归分析相关影响因素.结果 aids并发重症肺炎病原谱依次为肺孢子菌( 64/95,67.4％)、细菌(61/95,64.2％)、真菌(50/95,52.6％)、结核分枝杆菌(27/95,28.4％)、巨细胞病毒( 25/95,26.3％),其中80例(80/95,84.2％)为两种以上病原感染,15例(15/95,15.8％)为单一病原感染.logistic回归分析显示,需要机械通气、高ldh水平、有严重基础疾病是aids并发重症肺炎死亡的危险因素,高白蛋白水平是aids并发重症肺炎的预后保护性因素.结论 aids并发重症肺炎病原以肺孢子菌、细菌、真菌感染为主,多种病原感染多见.; abstract：; objective to investigate the pathogens and prognostic factors of aids-associated severe pneumonia. methods clinical data were collected from 95 patients with aids-associated severe pneumonia admitted to guangzhou no. 8 people' s hospital from january 2005 to december 2008. the pathogens of pulmonary infections were investigated. univariate analysis and multivariate logistic regression analysis were performed to study the relationships between the outcome and influencing factors. results the most prevalent pathogen was pneumocystis jirovecii (64/95, 67.4％ ), followed by bacteria (61/95, 64.2％ ),fungi ( 50/95, 52. 6％ ), mycobacterium tuberculosis ( 27/95, 28. 4％ ) and cytomegalovirus ( cmv ) (25/95, 26.3％ ). among 95 cases, monocontamination was detected in 15 cases ( 15.8％ ), while mixed infection in 80 cases (84. 2％ ). logistic regression analysis showed that mechanical ventilation, higher serum lactic dehydrogenase (ldh) level and severe underlying diseases were risk factors for the death of aids-associated severe pneumonia, and higher serum albumin level was the protective factor. conclusion pneumocystis jirovecii, bacteria and fungi are the main pathogens for aids-associated severe pneumonia, and mixed infection is popular.