CD4+T淋巴细胞计数与HIV感染者胆囊切除术后肺部并发症的相关性研究

doi:10.19871/j.cnki.xfcrbzz.2025.05.006

摘要/Abstract

摘要： 目的分析CD4+T淋巴细胞计数与HIV感染者胆囊切除术后肺部并发症（包括术后细菌性肺炎、真菌性肺炎、胸膜炎及胸腔积液、呼吸衰竭和其他肺部严重不良事件）之间的相关性,评估CD4+T淋巴细胞计数作为HIV感染者胆囊切除术后肺部并发症预测指标的可行性,旨在为减少术后肺部并发症的发生以及优化HIV感染者围手术期管理提供参考依据。方法回顾性分析2017年6月至2024年11月成都市公共卫生临床医疗中心接受胆囊切除术的122例HIV感染者的临床资料,采用二元Logistic回归分析CD4+T淋巴细胞计数与胆囊切除术后肺部并发症的相关性。结果 122例HIV感染者中,女性53例（43.44%）,男性69例（56.56%）,平均年龄（50.24±11.97）岁。CD4+T淋巴细胞计数中位数为366（246,481）cells/µl,HIV感染者胆囊切除术后肺部并发症发生率为16.39%。单因素Logistic回归分析显示,CD4+T淋巴细胞计数与胆囊切除术后肺部并发症存在统计学关联（OR=0.996, 95%CI：0.993~0.999,P=0.021）,进一步分析结果显示,以CD4+T淋巴细胞计数<200cells/µl的HIV感染者作为对照组,CD4+T淋巴细胞计数≥500cells/µl的HIV感染者,其胆囊切除术后肺部并发症发生风险显著降低（OR=0.154, 95%CI：0.028~0.843,P=0.031）,调整混杂因素后,其发生风险依然显著降低 (OR=0.169, 95%CI：0.029~0.997,P<0.050) 。结论 CD4+T淋巴细胞计数≥500cells/µl的HIV感染者胆囊切除术后发生肺部并发症的风险较低。HIV感染者接受手术治疗时,应进行有效的抗病毒治疗,以确保患者维持足够的CD4+T淋巴细胞数量,从而降低术后肺部并发症的发生风险。

关键词: CD4+T淋巴细胞, HIV感染, 胆囊切除术, 术后肺部并发症, 相关性研究

Abstract: Objective To analyze the correlation between CD4+T lymphocyte count and postoperative pulmonary complications (including bacterial pneumonia, fungal pneumonia, pleuritis, pleural effusion, respiratory failure and other serious adverse events in the lungs) in patients with HIV infection who underwent cholecystectomy. The aim is to provide a reference for reducing postoperative pulmonary complications and optimizing perioperative management in HIV-infected patients. Method A retrospective analysis was conducted on the clinical data of 122 HIV-infected patients who underwent cholecystectomy at the Chengdu Public Health Clinical Medical Center between June 2017 and November 2024. Logistic regression analysis was used to evaluate the correlation between CD4+T cell count and postoperative pulmonary complications. Result Among the 122 HIV-infected patients, 53（43.44%）were female and 69 （56.56%）were male, with an average age of (50.24±11.97) years. The median CD4+T cell count was 366 (246, 481) cells/µl, and the incidence of postoperative pulmonary complications was 16.39%. Statistically significant association was observed between CD4+T cell count and postoperative pulmonary complications (OR=0.996, 95%CI：0.993-0.999,P=0.021), further stratified analysis revealed significant findings. Using HIV-infected patients with CD4+T cell counts <200 cells/µl as the reference group, those with CD4+T cell counts ≥500 cells/µl demonstrated a negative correlation with postoperative pulmonary complications (OR=0.154, 95%CI：0.028-0.843,P=0.031). This negative association persisted after adjusting for confounding factors (OR=0.169, 95%CI：0.029-0.997,P<0.050). Conclusion The risk of pulmonary complications after cholecystectomy in HIV-infected patients was lower when the CD4+T lymphocyte count was ≥500 cells/µl. Effective antiviral therapy should be administered to HIV-infected patients to maintain adequate CD4+T lymphocyte count and and thereby reduce the risk of postoperative pulmonary complications.

Key words: CD4+T lymphocytes, HIV infection, Cholecystectomy, Postoperative pulmonary complications, Correlation study

中图分类号:

R51
R731.4

冯仕锋, 成兴真, 赵勇, 陈廷玉, 刘东旭, 魏国. CD4+T淋巴细胞计数与HIV感染者胆囊切除术后肺部并发症的相关性研究[J]. 新发传染病电子杂志, 2025, 10(5): 30-35.

Feng Shifeng, Cheng Xingzhen, Zhao Yong, Chen Tingyu, Liu Dongxu, Wei Guo. Research on the relationship between CD4+T cell count and postoperative pulmonary complications in hiv-positive patients after cholecystectomy[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(5): 30-35.

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