878例艾滋病合并结核病患者发生贫血状况及相关影响因素分析

doi:10.19982/j.issn.1000-6621.20260093

中国防痨杂志 ›› 2026, Vol. 48 ›› Issue (9): 1307-1314.doi: 10.19982/j.issn.1000-6621.20260093

878例艾滋病合并结核病患者发生贫血状况及相关影响因素分析

张爱华¹, 许萌¹, 杨宇英², 苏爽¹, 宋磊³, 马丹丹⁴, 魏素霞², 程俊伟⁵, 付朝红⁶()

¹ 河南省传染病医院(郑州市第六人民医院)护理部, 郑州 450000
² 河南省传染病医院(郑州市第六人民医院)中老年结核病科, 郑州 450000
³ 河南省传染病医院(郑州市第六人民医院)临床营养科, 郑州 450000
⁴ 河南省传染病医院(郑州市第六人民医院)感染一科, 郑州 450000
⁵ 河南省传染病医院(郑州市第六人民医院)介入结核病科, 郑州 450000
⁶ 河南省传染病医院(郑州市第六人民医院)院长办公室, 郑州 450000

收稿日期:2026-02-14 出版日期:2026-09-10 发布日期:2026-09-08
通信作者: 付朝红 E-mail:fuchaohong123@163.com
基金资助:
河南省科技攻关计划项目(242102310244);郑州市医疗卫生领域科技创新指导计划项目(2024YLZDJH379);郑州市医疗卫生领域科技创新指导计划项目(2025YLZDJH118)

Analysis of the incidence of anemia and related risk factors in 878 AIDS patients with tuberculosis

Zhang Aihua¹, Xu Meng¹, Yang Yuying², Su Shuang¹, Song Lei³, Ma Dandan⁴, Wei Suxia², Cheng Junwei⁵, Fu Chaohong⁶()

¹ Department of Nursing, Henan Provincial Infectious Disease Hospital (Zhengzhou Sixth People’s Hospital), Zhengzhou 450000, China
² Department of Tuberculosis in Middle-aged and Elderly Patients, Henan Provincial Infectious Disease Hospital (Zhengzhou Sixth People’s Hospital), Zhengzhou 450000, China
³ Department of Clinical Nutrition, Henan Provincial Infectious Disease Hospital (Zhengzhou Sixth People’s Hospital), Zhengzhou 450000, China
⁴ First Department of Infectious Diseases, Henan Provincial Infectious Disease Hospital (Zhengzhou Sixth People’s Hospital), Zhengzhou 450000, China
⁵ Department of Interventional Tuberculosis, Henan Provincial Infectious Disease Hospital (Zhengzhou Sixth People’s Hospital), Zhengzhou 450000, China
⁶ President’s Office, Henan Provincial Infectious Disease Hospital (Zhengzhou Sixth People’s Hospital), Zhengzhou 450000, China

Received:2026-02-14 Online:2026-09-10 Published:2026-09-08
Contact: Fu Chaohong E-mail:fuchaohong123@163.com
Supported by:
Henan Provincial Science and Technology Research Program Project(242102310244);Zhengzhou Municipal Science and Technology Innovation Guidance Program Project in the Healthcare Sector(2024YLZDJH379);Zhengzhou Municipal Science and Technology Innovation Guidance Program Project in the Healthcare Sector(2025YLZDJH118)

摘要/Abstract

摘要：

目的: 分析河南省艾滋病合并结核病患者的贫血发生情况及其影响因素。 方法: 回顾性收集2021年1月至2025年11月在河南省传染病医院住院的878例艾滋病合并结核病患者的临床资料,分析其贫血发生情况及其影响因素。 结果: 878例艾滋病合并结核病患者的贫血发生率为61.39%(539/878)。多因素logistic回归分析结果显示,合并肺外结核(OR=0.640,95%CI:0.432~0.947)、抗结核疗程为6~24个月(OR=0.605,95%CI:0.428~0.855)和CD4⁺ T细胞计数>200个/μl(201~349个/μl:OR=0.320,95%CI:0.216~0.474;350~499个/μl:OR=0.159,95%CI:0.094~0.272;≥500个/μl:OR=0.051,95%CI:0.021~0.122)的患者发生贫血的风险均较低。 结论: 河南省艾滋病合并结核病患者发生贫血的比例较高,应重点关注合并肺结核、抗结核疗程<6个月、CD4⁺ T细胞计数≤200个/μl的患者,以制定并实施科学、合理的干预措施,降低贫血发生的风险。

关键词: 获得性免疫缺陷综合征, 结核, 贫血, 共病现象, 因素分析,统计学

Abstract:

Objective: To analyze the incidence and influencing factors of anemia in AIDS patients with tuberculosis in Henan Province. Methods: The clinical data of 878 patients with AIDS complicated by tuberculosis who were hospitalized in Henan Provincial Infectious Disease Hospital from January 2021 to November 2025 were retrospectively collected. The incidence of anemia and its influencing factors were analyzed. Results: The incidence of anemia among the 878 AIDS patients with tuberculosis in Henan Province was 61.39% (539/878). The results of multivariate logistic analysis showed that patients with extrapulmonary tuberculosis (OR=0.640, 95%CI: 0.432-0.947), antituberculosis treatment course of 6-24 months (OR=0.605, 95%CI: 0.428-0.855), or a CD4⁺ T-cell count >200 cells/μl (201-349 cells/μl: OR=0.320, 95%CI: 0.216-0.474; 350-499 cells/μl: OR=0.159, 95%CI: 0.094-0.272; ≥500 cells/μl: OR=0.051, 95%CI: 0.021-0.122) had a lower risk of anemia. Conclusion: The proportion of anemia in AIDS patients with tuberculosis in Henan Province is high. It is necessary to focus on patients with pulmonary tuberculosis, antituberculosis treatment course <6 months, and CD4⁺ T cell count ≤200/μl, so as to formulate and implement scientific and reasonable intervention measures to reduce the incidence of anemia risk.

Key words: Acquired immunodeficiency syndrome, Tuberculosis, Anemia, Comorbidity, Factor analysis, statistical

中图分类号:

R521

张爱华, 许萌, 杨宇英, 苏爽, 宋磊, 马丹丹, 魏素霞, 程俊伟, 付朝红. 878例艾滋病合并结核病患者发生贫血状况及相关影响因素分析[J]. 中国防痨杂志, 2026, 48(9): 1307-1314. doi: 10.19982/j.issn.1000-6621.20260093

Zhang Aihua, Xu Meng, Yang Yuying, Su Shuang, Song Lei, Ma Dandan, Wei Suxia, Cheng Junwei, Fu Chaohong. Analysis of the incidence of anemia and related risk factors in 878 AIDS patients with tuberculosis[J]. Chinese Journal of Antituberculosis, 2026, 48(9): 1307-1314. doi: 10.19982/j.issn.1000-6621.20260093

图/表 4

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特征	例数(构成比,%)	特征	例数(构成比,%)
性别		有饮酒史	301(34.28)
男性	710(80.87)	居住地
女性	168(19.13)	农村	684(77.91)
年龄组(岁)		城市	183(20.84)
<40	343(39.07)	看守所	11(1.25)
40~60	400(45.56)	合并结核病类型
>60	135(15.37)	肺结核	444(50.57)
职业		肺外结核	175(19.93)
无业人员/离(退)休人员	107(12.19)	肺结核+肺外结核	259(29.50)
农民	491(55.92)	HIV感染确诊时长(月)
自由职业	178(20.27)	<6	273(31.09)
其他	102(11.62)	6~24	175(19.93)
婚姻状况		>24	430(48.98)
未婚	196(22.32)	抗结核疗程(月)
已婚	565(64.35)	<6	588(66.97)
离婚/丧偶	117(13.33)	6~24	215(24.49)
文化程度		>24	75(8.54)
文盲	67(7.63)	痰涂片/培养
小学	194(22.10)	阴性	665(75.74)
初中	358(40.77)	阳性	213(24.26)
中专/高中	139(15.83)	CD4⁺T细胞计数(个/μl)
大专及以上	120(13.67)	≤200	619(70.50)
医疗保障		201~349	131(14.92)
无	132(15.03)	350~499	75(8.54)
有	746(84.97)	≥500	53(6.04)
吸烟史		HIV-RNA定量(拷贝/ml)
从不吸烟	518(59.00)	≤1000	421(47.95)
有吸烟史	360(41.00)	1001~3000	31(3.53)
饮酒史		3001~5000	16(1.82)
从不饮酒	577(65.72)	>5000	410(46.70)

序号	变量	赋值
Y	贫血	无=0;有=1
X₁	居住地	农村=0;城市=1;看守所=2
X₂	痰涂片/培养	阴性=0;阳性=1
X₃	结核病类型	肺结核=0;肺外结核=1;肺结核+肺外结核=2
X₄	HIV感染确诊时长	<6个月=0;6~24个月=1;>24个月=2
X₅	抗结核疗程	<6个月=0;6~24个月=1;>24个月=2
X₆	CD4⁺T细胞计数	≤200个/μl=0;201~349个/μl=1;350~499个/μl=2;≥500个/μl=3

因素	β值	s${}_{\overline{\mathit{x}}}$值	Wald χ²值	P值	OR(95%CI)值
合并结核病类型
肺结核				0.045	1.000
肺外结核	-0.447	0.200	4.992	0.025	0.640(0.432~0.947)
肺结核+肺外结核	0.053	0.179	0.087	0.768	1.054(0.742~1.499)
抗结核疗程(月)
<6				0.015	1.000
6~24	-0.503	0.176	8.113	0.004	0.605(0.428~0.855)
>24	-0.280	0.278	1.016	0.313	0.756(0.439~1.302)
CD4⁺T细胞计数(个/μl)
≤200				<0.001	1.000
201~349	-1.140	0.200	32.401	<0.001	0.320(0.216~0.474)
350~499	-1.836	0.272	45.499	<0.001	0.159(0.094~0.272)
≥500	-2.976	0.447	44.409	<0.001	0.051(0.021~0.122)

878例艾滋病合并结核病患者发生贫血状况及相关影响因素分析

Analysis of the incidence of anemia and related risk factors in 878 AIDS patients with tuberculosis

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