摘要
目的探讨影响艾滋病合并淋巴瘤患者预后的危险因素。方法选取广州市第八人民医院2011年8月至2014年7月因淋巴瘤住院的32例艾滋病患者，随访2～48个月（中位数9个月），对影响其预后的因素进行Logistic回归分析。结果32例患者中，男27例，女5例，发病年龄4～70岁，平均（42.8±13.5）岁。淋巴瘤临床诊断分期：Ⅰ期6例（18.8%），Ⅱ期4例（12.5%），Ⅲ期5例（15.6%）和Ⅳ期17例（53.1%）。国际预后指数（IPI）评分：低危组（IPI 0～1） 4例（12.5%），低中危组（IPI 2） 5例（15.6%），中高危组（IPI 3） 8例（25.0%），高危组（IPI 4～5） 15例（46.9%）。病理诊断分类：B细胞非霍奇金淋巴瘤（NHL）26例（81.2%），T细胞NHL 4例（12.5%），霍奇金淋巴瘤（HL）结节硬化型2例（6.2%）。共23例（71.9%）患者于就诊前或诊断淋巴瘤后1个月内接受HAART。16例（50.0%）患者按照肿瘤科专家会诊制订的方案进行规范化学治疗。32例患者中死亡17例（53.1%），生存15例（46.9%）。单因素分析显示，预后影响因素包括年龄（OR＝0.915，P＝0.012）、治疗前乳酸脱氢酶水平（OR＝1.006，P＝0.021）、是否接受HAART（OR＝12.444，P＝0.011）和规范性化学治疗（OR＝13.000，P＝0.001）。经多因素Logistic回归分析发现，是否接受规范化学治疗是影响艾滋病合并淋巴瘤预后的重要因素（OR＝0.035，P＝0.022）。结论艾滋病合并淋巴瘤病死率高，以NHL为主。在HAART基础上给予规范化学治疗可改善预后。
Objective To explore the risk factors for the prognosis of acquired immunodeficiency syndrome （AIDS）-related lymphoma （ARL）. Methods A total of 32 patients with ARL were enrolled in this study from Guangzhou Eighth People＇s Hospital during August 2011 and July 2014, who were followed up for 2 to 48 months （median 9 months）. The risk factors for the prognosis of ARL were analyzed by Logistic regression analysis. Results A total of 32 patients were included, among whom 27 were males and the rest were females, with a mean age of （42. 8% 13. 5） years （ranging from 4 to 70 years）. Regarding the clinical staging at the initial diagnosis, 6 cases （18.8%） were classified as stage I , 4 cases （12. 5%） stage 11, 5 cases （15. 6%） stage HI, and 17 cases （53. 1%） stage IV. As for international prognostic index （IPI） score, 4 cases （12.5%） were in the low risk group （IPI 0--1）, 5 cases （15.6%） in the low-middle group （IPI 2）, 8 cases （25.0%） in the middle-high risk group （IPI 3）, and 15 cases （46.9%//oo） in the high risk group （IPI 4--5）. According to the pathological diagnosis, 26 cases （81.2%） were B cell non-Hodgkin lymphoma （NHL）, 4 cases （12.5%） were T cell NHL, and 2 cases （6.2%） were Hodgkin lymphoma （HL） nodular sclerosis. In total, 23 cases （71.9%） had received highly active antiretroviral therapy （HAART） before the first hospital visit or within one month after the diagnosis of lymphoma. Sixteen （50.0%） cases received standard chemotherapy regimen formulated by the oncology specialists. A total of 17 patients died, with the mortality rate of 53. 1%. By univariateanalysis, the prognostic factors included age （OR=0. 915, P=0. 012）, high lactate dehydrogenase （OR% 1. 006, P = 0. 021） value at baseline, receiving HAART （（）R = 12. 444, P = 0. 011）, and standard chemotherapy regimen （OR= 13. 000, P= 0. 001）. By multivariate Logistic regression, receiving standard chemotherapy regimen （OR=0. 035, P=0. 022） was the only prognostic factor of ARL. Conclusions The mortality of ARL is high and the most common pathological type was NHL. The prognosis could be improved by standard chemotherapy regimen on the basis of HAART.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2016年第8期475-479,共5页
Chinese Journal of Infectious Diseases
