| Objective To analyze the clinical characteristics and prognostic risk factors of HIV negative Pneumocystis jirovecii pneu-monia (PJP), so as to provide reference for clinical diagnosis and treatment.Methods Medical records and treatment outcomes of 51 adult HIV negative PJP inpatients admitted to Fuyang People's Hospital from December 2021 to October 2023 were collected. Accord-ing to the prognosis, patients were assigned into a survival group and a death group, and their general information, clinical data, andtreatment outcomes were compared between the two groups. Variables were included in univariate and multivariate logistic regressionto screen for risk factors related to prognosis, and a receiver operating characteristic curve (ROC curve) was established to evaluate theprognosis model.Results Most of the 51 hospitalized HIV negative PJP patients (84.31%, 43/51) had mixed infections, with Aspergil-lus being the most common at 37.21% (16/43). The main risk factors were interstitial lung disease (23.53%, 12/51) and hormone use(52.94%, 27/51). The imaging findings mainly showed ground glass opacities on the lungs, accounting for 82.35% (42/51). The mainclinical symptoms were dyspnea (76.47%, 39/51), cough (64.71%, 33/51), and fever (60.78%, 31/51). The white blood cell count, neu-trophil ratio, C-reactive protein (CRP), and lactate dehydrogenase (LDH) in the death group of HIV negative PJP patients were all high-er than those in the survival group [(10.85±4.50) ×109/L vs. (6.97±3.00) ×109/L, (88.20±4.74)% vs. (70.93±14.97)% , 139.45 (95.37, 263.17) mg/L vs. 32.82 (12.16,101.71) mg/L, 600.15 (469.90,771.65) U/L vs. 301.0 (234.8,398.7) U/L] (P<0.05). The lymphocyte ratio and albumin in the death group were lower than those in the survival group [8.45 (4.93, 10.28)% vs. 15.80 (9.00, 27.00)%, (30.88±4.16) g/L vs. (34.30±5.12) g/L, respectively] (P<0.05). Multivariate logistic regression analysis found that the independent risk factors fordeath in HIV negative PJP patients were CRP [OR=1.02, 95%CI: (1.00, 1.03), P=0.023] and LDH [OR=1.01, 95%CI:(1.00, 1.02), P=0.009]. ROC curves were established using LDH, CRP, and their combination, with areas under the curves of 0.92, 0.85, and 0.95, re-spectively.Conclusions HIV negative PJP is mostly a mixed infection, mainly manifested as dyspnea, cough, and fever. Imaging find-ings mainly show ground glass opacities on both lungs. The white blood cell count, neutrophil ratio, lymphocyte ratio, CRP, albumin,AST, LDH, and D-dimer affect prognosis. LDH and CRP are independent risk factors for poor prognosis. |
