- 作者：Xian-jun Xia ; M.S. ; Bao-chi Liu ; M.D. ; liubaochi2002@yahoo.com.cn ; Jin-song Su ; M.D. ; Hui Pei ; M.D. ; Hui Chen ; M.S. ; Lei Li ; M.S. ; Yong-fu Liu ; M.S.
- 关键词：HIV/AIDS ; sepsis ; CD4 count ; CD4/CD8 ratio
- 刊名：Journal of Surgical Research
- 出版年：2012
- 期刊代码：299_00224804
- 类别：med
- 出版时间：1 May, 2012
- 卷：174
- 期：1
- 页码：e25-e30
- 文件大小：188 K
Background
CD4 count or CD4/CD8 ratio has been found to be a valuable marker of disease progression in HIV and AIDS. Our objective was to evaluate preoperative CD4 count or CD4/CD8 ratio as a useful indicator for postoperative sepsis in HIV-infected patients undergoing abdominal operations.Methods
Retrospective analysis of 35 HIV-infected patients (four females, 31 males) undergoing abdominal operations. All patients were divided into postoperative sepsis group (A) and non-sepsis group (B). Demographic and clinical information were entered into a database and included: type of surgical procedure, age, peripheral blood cells, plasma albumin, CD4 counts, and CD4/CD8 ratios. Furthermore, we stratified and compared the incidence of postoperative sepsis according to the preoperative CD4 counts with breakpoint value of 200 cells/渭L and preoperative CD4/CD8 ratios with breakpoint value of 0.15.
Results
Overall postoperative sepsis morbidity in our study was 51.43%(18/35). In sepsis group, the mean preoperative and postoperative CD4 counts, CD4/CD8 ratios, and postoperative platelet count were found significantly lower, respectively, than those in non-sepsis group (P < 0.05). The incidence of postoperative sepsis in the patients with preoperative CD4 counts 鈮?200 cells/渭L was markedly higher than those with CD4 counts > 200 cells/渭L (83.3%versus 17.65%; P = 0.000). Likewise, the incidence of postoperative sepsis in the patients with preoperative CD4/CD8 ratios 鈮?0.15 was dramatically higher than those with CD4/CD8 ratios > 0.15 (90%versus 36%; P = 0.007).
Conclusions
Our preliminary study showed that HIV-infected patients with preoperative CD4 count 鈮?200 cells/渭L or CD4/CD8 ratio 鈮?0.15 had overall higher postoperative sepsis morbidity. Preoperative CD4 count or CD4/CD8 ratio may be used as a useful indicator for postoperative sepsis in HIV-infected patients undergoing abdominal operations.