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目的分析获得性免疫缺陷综合征(AIDS)相关肺孢子菌肺炎(PCP)患者复合感染的情况及与CD_4~+ T细胞数的相关性。方法选取2012-2016年在杭州市西溪医院感染二科住院的AIDS患者147例,其中AIDS合并PCP感染患者60例,AIDS未合并PCP感染患者87例;将AIDS合并PCP患者中复合感染组与无复合感染组CD_4~+ T细胞数、CD_8~+ T细胞数以及CD_4~+ T/CD_8~+ T细胞比值进行比较,并进一步分析不同CD_4~+ T细胞数水平发生复合感染情况。结果 60例PCP患者中有47例发生复合感染,感染率为78.33%;其主要的复合感染是口腔念珠菌病、巨细胞病毒感染、细菌性肺炎、梅毒、乙型病毒性肝炎,感染率分别为41.67%、31.67%、31.67%、30.00%、11.67%;AIDS相关PCP患者CD_4~+ T细胞数均<200×10~6/L,且绝大多数≤50×10~6/L;复合感染组CD_4~+ T细胞数、CD_4~+ T/CD_8~+ T细胞比值显著低于无复合感染组(P<0.01,P<0.05);CD_4~+ T细胞数≤50×10~6/L组患者复合感染率为90.91%,显著高于CD_4~+ T细胞数51~100×10~6/L组(57.14%)、101~200×10~6/L组(33.33%),差异有统计学意义(P<0.017)。结论 AIDS相关PCP患者复合感染率高,AIDS合并PCP患者感染的病原体多种多样,且CD_4~+ T细胞数与AIDS合并PCP患者复合感染关系密切,随着CD_4~+ T细胞水平降低,机体免疫力下降,合并多种机会性感染的可能性进一步增加。
Objective To analyze the co-infection status of patients with Acquired Immunodeficiency Syndrome (AIDS) -related Pneumocystis pneumonia (PCP) and the correlation with the number of CD_4 ~ + T cells. Methods A total of 147 AIDS patients hospitalized in Xixi Hospital of Hangzhou from 2012 to 2016 were selected, including 60 AIDS patients with PCP infection and 87 AIDS patients without PCP infection. The AIDS patients with AIDS complicated with PCP were compared with those without The number of CD_4 ~ + T cells, CD_8 ~ + T cells and CD_4 ~ + T / CD_8 ~ + T cells in the composite infection group were compared, and the number of CD_4 ~ + T cells was analyzed. Results Of 60 PCP patients, 47 cases were complicated with infection, the infection rate was 78.33%. The main complex infections were oral candidiasis, cytomegalovirus infection, bacterial pneumonia, syphilis and hepatitis B, the infection rates were Were 41.67%, 31.67%, 31.67%, 30.00% and 11.67%, respectively. The number of CD_4 ~ + T cells in AIDS-related PCP patients was less than 200 × 10 ~ 6 / L and most of them were ≤50 × 10 ~ 6 / The number of CD_4 ~ + T cells and the ratio of CD_4 ~ + T / CD_8 ~ + T cells in infected group were significantly lower than those without complex infection (P <0.01, P <0.05) The combined infection rate of L group was 90.91%, which was significantly higher than that of 51 ~ 100 × 10 ~ 6 / L CD_4 ~ + T cells (57.14%) and 101 ~ 200 × 10 ~ 6 / L group There was statistical significance (P <0.017). Conclusions The prevalence of complex infection in AIDS-related PCP patients is very high. The number of CD4 + T cells infected by AIDS in combination with PCP is closely related to the co-infection of PCP in AIDS patients. With the decrease of CD_4 ~ + T cells, Decreased force, the possibility of combining multiple opportunistic infections further increased.