CURB-65和qSOFA联合血清标志物和HRCT预测艾滋病合并乙型肺囊虫肺炎死亡率的比较

Sitong Wang, Yunlong Xue
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引用次数: 0

摘要

目的:评价和比较CURB-65和qSOFA评分结合血清标志物和HRCT评分评估获得性免疫缺陷综合征(AIDS)合并肺囊虫肺炎(PJP)患者死亡风险的临床预测价值。研究设计:描述性分析研究。研究地点和时间:首都医科大学北京友安医院呼吸与重症医学科,中国北京,2022年1月- 12月。方法:将艾滋病合并PJP患者根据预后分为两组:非幸存者(n = 35)和幸存者(n = 85)。收集临床资料如WBC计数、CRP、PCT、CD4+ T淋巴细胞计数等。计算CURB-65、qSOFA和HRCT评分。采用logistic回归分析确定死亡率的独立危险因素,并采用ROC曲线下面积(AUC)评估其临床预测价值。结果:非幸存者组机械通气时间更长,气管插管率更高,WBC计数、CRP、PCT、CURB-65评分、qSOFA评分和HRCT评分均低于幸存者组,但CD4+ T淋巴细胞计数低于幸存者组(p)。结论:CURB-65评分、HRCT评分和WBC计数联合可有效评估艾滋病合并PJP患者的疾病严重程度和死亡风险。关键词:获得性免疫缺陷综合征,耶氏肺囊虫肺炎,CURB-65评分和qSOFA评分,血清标志物,HRCT评分,死亡率预测
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of CURB-65 and qSOFA Combined with Serum Markers and HRCT in Predicting Mortality in AIDS with Pneumocystis jirovecii Pneumonia.

Objective: To evaluate and compare the clinical predictive value of the CURB-65 and qSOFA scores, combined with serum markers and HRCT scores, in assessing mortality risk in Acquired Immunodeficiency Syndrome (AIDS) patients with Pneumocystis jirovecii pneumonia (PJP).

Study design: Descriptive analytical study. Place and Duration of the Study: Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China, from January to December 2022.

Methodology: Patients with AIDS and PJP were divided into two groups based on prognosis: Non-survivors (n = 35) and survivors (n = 85). Clinical data such as WBC count, CRP, PCT, CD4+ T lymphocyte count, and so on were collected. CURB-65, qSOFA, and HRCT scores were calculated. Independent risk factors for mortality were identified using logistic regression analysis, and their clinical predictive value was assessed using the area under the ROC curve (AUC).

Results: The non-survivors group had longer mechanical ventilation duration, higher rate of tracheal intubation, WBC count, CRP, PCT, CURB-65 score, qSOFA score, and HRCT score, but lower CD4+ T lymphocyte count than the survivors group (p <0.05). Univariate and multivariate logistic regression identified WBC count 1.15 × 109/L, CURB-65 score (14), qSOFA score (11.02), and HRCT score (1.37) as independent risk factors for mortality in AIDS patients with PJP (p <0.05). ROC analysis showed that CURB-65 had better predictive value than qSOFA for individual indicators (p <0.001), and CURB-65 + HRCT + WBC outperformed qSOFA+ HRCT + WBC for combined indicators (p <0.001).

Conclusion: The combination of the CURB-65 score, HRCT score, and WBC count may effectively assess disease severity and mortality risk in AIDS patients with PJP.

Key words: Acquired immunodeficiency syndrome, Pneumocystis jirovecii pneumonia, CURB-65 score and qSOFA score, Serum markers, HRCT score, Mortality prediction.

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