CAJ | 학술논문

[目的]探讨上海市2个区未接受抗病毒治疗的艾滋病病毒（ HIV）感染者CD4＋T淋巴细胞计数的自然变化特征及其影响因素。[方法]对1987-2013年5月期间上海市2个城区报告的未接受抗病毒治疗，或抗病毒治疗前至少有2次CD4＋T淋巴细胞计数结果的HIV感染者开展回顾性研究，描述CD4＋T淋巴细胞计数自然变化特征，并分析其显著下降的影响因素。[结果]共纳入调查对象365例，CD4＋T淋巴细胞计数月均自然变化速率的中位数M＝-4．4（IQR：-11．1～0．2）个/μL，其中263例（72．1％）HIV感染者末次CD4＋T淋巴细胞计数结果低于首次，显著下降（≥30％）率为39．2％（143/365）。 Logistic多因素回归分析结果显示：HIV感染者CD4＋T淋巴细胞计数显著下降率与年龄、首次CD4＋T淋巴细胞计数水平及首末次CD4＋T淋巴细胞计数检测间隔时间存在统计学关联。[结论] HIV感染者治疗前CD4＋T淋巴细胞计数自然变化总体平缓，部分感染者CD4＋T淋巴细胞计数快速下降与多种因素相关。应定期监测CD4＋T淋巴细胞计数水平和变化速率，及时评估病情进展，开展有针对性的行为干预和临床干预。
[목적]탐토상해시2개구미접수항병독치료적애자병병독（ HIV）감염자CD4＋T림파세포계수적자연변화특정급기영향인소。[방법]대1987-2013년5월기간상해시2개성구보고적미접수항병독치료，혹항병독치료전지소유2차CD4＋T림파세포계수결과적HIV감염자개전회고성연구，묘술CD4＋T림파세포계수자연변화특정，병분석기현저하강적영향인소。[결과]공납입조사대상365례，CD4＋T림파세포계수월균자연변화속솔적중위수M＝-4．4（IQR：-11．1～0．2）개/μL，기중263례（72．1％）HIV감염자말차CD4＋T림파세포계수결과저우수차，현저하강（≥30％）솔위39．2％（143/365）。 Logistic다인소회귀분석결과현시：HIV감염자CD4＋T림파세포계수현저하강솔여년령、수차CD4＋T림파세포계수수평급수말차CD4＋T림파세포계수검측간격시간존재통계학관련。[결론] HIV감염자치료전CD4＋T림파세포계수자연변화총체평완，부분감염자CD4＋T림파세포계수쾌속하강여다충인소상관。응정기감측CD4＋T림파세포계수수평화변화속솔，급시평고병정진전，개전유침대성적행위간예화림상간예。
Objective Objective To explore the characteristics and determinants of natural chan-ges in CD4+lymphocyte counts among HIV -infected patients without previous antiviral therapy in two dis-tricts of Shanghai . [ Methods] A retrospective study was conducted on HIV -infected patients reported from 1987 through May 2013 in two districts of Shanghai , who had received at least twice CD 4+lymphocyte counting tests before antiretroviral treatment ( ART) .The characteristics of natural changes in CD 4+lympho-cyte count and the determinants of significant decrease in count were described . [ Results] A total of 365 patients were included in the study .The monthly rate of CD 4+lymphocyte count changes between the first and the last counting tests had a median of -4.4 (IQR:-11.1~0.2).Among them 263(72.1%) showed remarkable decrease in CD 4+lymphocyte counts and 143 ( 39 .2%) presented a significant decrease (≥30%).Multiple logistic regression analysis indicated that the age , the first CD4+lymphocyte counts and the interval between the first and the last counting tests were significantly associated with the significant de -crease of CD4+lymphocyte counts among HIV-infected patients. [Conclusion] Natural changes of CD4+lymphocyte counts were gentle as a whole among untreated patients infected with HIV in central districts of Shanghai and rapid decrease in CD 4+lymphocyte counts among some HIV -infected patients was associated with many factors .It is held that CD 4+lymphocyte count and its changing rate should be regularly monitored so as to estimate the progress of the disease and perform targeted behavior intervention and clinic intervention .