中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2008年
12期
1176-1180
,共5页
丁盈盈%贾望谦%王晋生%董少良%杨清海%周仁义%曲淑霞%陆立星%卫军%乔晓春%高眉扬%郭晓黎%张铁军%吴尊友%何纳
丁盈盈%賈望謙%王晉生%董少良%楊清海%週仁義%麯淑霞%陸立星%衛軍%喬曉春%高眉颺%郭曉黎%張鐵軍%吳尊友%何納
정영영%가망겸%왕진생%동소량%양청해%주인의%곡숙하%륙립성%위군%교효춘%고미양%곽효려%장철군%오존우%하납
艾滋病%抗病毒治疗%生存分析
艾滋病%抗病毒治療%生存分析
애자병%항병독치료%생존분석
Acquired immune deficiency syndrom%Antiretroviral therapy%Survival analysis
目的 了解艾滋病病毒感染者/艾滋病患者(HIV/AIDS)接受国家免费抗病毒治疗后的依从性、免疫学变化和生存情况.方法 选择闻喜县2004年7月1日至2006年底所有纳入免费抗病毒治疗项目,且年满18周岁的HIV/AIDS纳入研究分析,所有患者在治疗前和治疗后的第0.5、1、2、3、6、9……个月均接受相关流行病学调查和实验室检查,监测服药依从性、CD4+T淋巴细胞计数变化和生存情况等.结果 病例平均随访时间为16.5个月[四分位距(IQR):15.5～20.8个月].经抗病毒治疗前,病例CD4+T淋巴细胞计数中位数值为154个/μl[四分位距(IQR):81～212个/μl];治疗后,CD4+T淋巴细胞计数均不同程度升高,治疗初3个月增长幅度最大,从基线水平的154个/μl上升到220个/μl(P<0.001),随后增长减缓,保持在相对稳定水平.相比基线CO4+T淋巴细胞计数≥100个/μl的病例,<100个/μl的病例治疗初3个月该细胞计数增长幅度更大.病例治疗后第3、12、24个月累计生存率分别为0.94、0.88和0.87,应用Cox比例风险回归模型做多因素分析发现,控制初始治疗方案(NVP组和EFV/IDV组)变量后,与基线CD4+T淋巴细胞计数<50个/μl比较,≥50个/μl的病例存活时间更长,死亡危险比(HR)为0.21(95%CI:0.06～0.68).结论 抗病毒治疗对HIV/AIDS具有较好的免疫学治疗效果;患者治疗后生存时间与基线CD4+T淋巴细胞计数水平密切相关.
目的 瞭解艾滋病病毒感染者/艾滋病患者(HIV/AIDS)接受國傢免費抗病毒治療後的依從性、免疫學變化和生存情況.方法 選擇聞喜縣2004年7月1日至2006年底所有納入免費抗病毒治療項目,且年滿18週歲的HIV/AIDS納入研究分析,所有患者在治療前和治療後的第0.5、1、2、3、6、9……箇月均接受相關流行病學調查和實驗室檢查,鑑測服藥依從性、CD4+T淋巴細胞計數變化和生存情況等.結果 病例平均隨訪時間為16.5箇月[四分位距(IQR):15.5～20.8箇月].經抗病毒治療前,病例CD4+T淋巴細胞計數中位數值為154箇/μl[四分位距(IQR):81～212箇/μl];治療後,CD4+T淋巴細胞計數均不同程度升高,治療初3箇月增長幅度最大,從基線水平的154箇/μl上升到220箇/μl(P<0.001),隨後增長減緩,保持在相對穩定水平.相比基線CO4+T淋巴細胞計數≥100箇/μl的病例,<100箇/μl的病例治療初3箇月該細胞計數增長幅度更大.病例治療後第3、12、24箇月纍計生存率分彆為0.94、0.88和0.87,應用Cox比例風險迴歸模型做多因素分析髮現,控製初始治療方案(NVP組和EFV/IDV組)變量後,與基線CD4+T淋巴細胞計數<50箇/μl比較,≥50箇/μl的病例存活時間更長,死亡危險比(HR)為0.21(95%CI:0.06～0.68).結論 抗病毒治療對HIV/AIDS具有較好的免疫學治療效果;患者治療後生存時間與基線CD4+T淋巴細胞計數水平密切相關.
목적 료해애자병병독감염자/애자병환자(HIV/AIDS)접수국가면비항병독치료후적의종성、면역학변화화생존정황.방법 선택문희현2004년7월1일지2006년저소유납입면비항병독치료항목,차년만18주세적HIV/AIDS납입연구분석,소유환자재치료전화치료후적제0.5、1、2、3、6、9……개월균접수상관류행병학조사화실험실검사,감측복약의종성、CD4+T림파세포계수변화화생존정황등.결과 병례평균수방시간위16.5개월[사분위거(IQR):15.5～20.8개월].경항병독치료전,병례CD4+T림파세포계수중위수치위154개/μl[사분위거(IQR):81～212개/μl];치료후,CD4+T림파세포계수균불동정도승고,치료초3개월증장폭도최대,종기선수평적154개/μl상승도220개/μl(P<0.001),수후증장감완,보지재상대은정수평.상비기선CO4+T림파세포계수≥100개/μl적병례,<100개/μl적병례치료초3개월해세포계수증장폭도경대.병례치료후제3、12、24개월루계생존솔분별위0.94、0.88화0.87,응용Cox비례풍험회귀모형주다인소분석발현,공제초시치료방안(NVP조화EFV/IDV조)변량후,여기선CD4+T림파세포계수<50개/μl비교,≥50개/μl적병례존활시간경장,사망위험비(HR)위0.21(95%CI:0.06～0.68).결론 항병독치료대HIV/AIDS구유교호적면역학치료효과;환자치료후생존시간여기선CD4+T림파세포계수수평밀절상관.
Objective To assess the adherence,immunologic and survival responses in HIV-infected patients receiving free antiretroviral therapy (ART). Methods All adult HIV-infected patients in Wenxi county who started antiretroviral treatment (ART) between 01 July 2001 and 31 December 2006 and aged above 18 years were included in this study. Epidemiological survey and laboratory tests were performed before,0.5 months after, 1 months after, 2 months after and every 3 months after initiation of ART to recognize the adherence, efficacy (CD4+ T cell counts) and survival to the regimens. Results The median follow-up time period was 16.5 months (Interquartile: 15.5-20.8 months). At baseline, the median of CD4+ T cell counts were 154 cells/μl (Interquartile: 81-212 cells/μl). Treatment was effective in most of the patients, the CD4+ T cell count of patients increased after the initiation of ART. The maximum increase was recorded at month 3, from the median of 154 cells/μl to 220 cells/μl (P<0.001) ,and thereafter the count remained stable. When comparing with patients with baseline CD4+ T cell count≥100 cells/μl, those with baseline CD4+ T cell count < 100 cells/μl showed a higher mean increase in the first three months of treatment. The cumulative probability rates of remaining alive were 0.94,0.88 and 0.87 at 3,12,24 months, respectively. In multivariate Cox's proportional hazard models, after adjustment for the type ofinitial regimens (NVP vs. EFV/IDV), CD4+T cell count of less than 50 cells/μl (vs. 50 cells/μl or more) was strongly associated with death hazard ratio 0.21 (95% CI:0.06-0.68). Conclusion Our data showed that ART was effective for improving immunologic response of adult patients with HIV/AIDS. CD4+ T cell count at initiation was associated with survival time in patients starting ART,suggesting that monitoring of CD4+ T count should be strengthened to early initiate antiretroviral therapy for HIV-infected patients.
