CAJ | 학술논문

目的了解中国部分艾滋病抗病毒治疗定点医院住院艾滋病患者的死亡原因及其相关影响因素.方法在7所省级艾滋病抗病毒治疗定点医院收集2009-2010年艾滋病住院死亡患者的死因及相关医疗信息,采用CoDe编码系统归类,应用logistic回归分析患者是否死于艾滋病相关原因的影响因素.结果 7所医院共收集381例艾滋病患者的临床医疗及死因信息,患者以男性为主(82.4％),30～ 45岁占多数,生前曾接受抗病毒治疗(ART)者占32.3％.252例(66.1％)死于艾滋病相关原因,其中机会性感染占92.4％,以结核菌、肺孢子菌、马尔尼菲青霉菌感染为主.在非艾滋病相关死亡原因中,前三位依次是非艾滋病相关感染、肝炎、非艾滋病相关肿瘤,分别占29.5％、22.5％、10.1％.患者死亡前一年内有注射吸毒行为、未接受ART、合并机会性感染、未合并肝炎及死亡前最近一次CD4+T淋巴细胞计数水平较低的病例,死于艾滋病相关原因的风险较高.结论机会性感染、非艾滋病相关感染、肝炎是艾滋病患者最主要的前三位死因,接受ART的患者死于非艾滋病相关原因的风险低于未接受ART者,且治疗时间越长,死于非艾滋病相关原因的比例越低.
목적 료해중국부분애자병항병독치료정점의원주원애자병환자적사망원인급기상관영향인소.방법 재7소성급애자병항병독치료정점의원수집2009-2010년애자병주원사망환자적사인급상관의료신식,채용CoDe편마계통귀류,응용logistic회귀분석환자시부사우애자병상관원인적영향인소.결과 7소의원공수집381례애자병환자적림상의료급사인신식,환자이남성위주(82.4％),30～ 45세점다수,생전증접수항병독치료(ART)자점32.3％.252례(66.1％)사우애자병상관원인,기중궤회성감염점92.4％,이결핵균、폐포자균、마이니비청매균감염위주.재비애자병상관사망원인중,전삼위의차시비애자병상관감염、간염、비애자병상관종류,분별점29.5％、22.5％、10.1％.환자사망전일년내유주사흡독행위、미접수ART、합병궤회성감염、미합병간염급사망전최근일차CD4+T림파세포계수수평교저적병례,사우애자병상관원인적풍험교고.결론 궤회성감염、비애자병상관감염、간염시애자병환자최주요적전삼위사인,접수ART적환자사우비애자병상관원인적풍험저우미접수ART자,차치료시간월장,사우비애자병상관원인적비례월저.
Objective In this study,researchers investigated the demographic and clinical characteristics of AIDS patients who died in hospitals,analyzed the specific causes of death,and looked for the correlation between specific cause of death and their clinical characteristics.Methods Data of clinical characteristics of patients and their specific causes AIDS of death who died in the seven hospitals from 2009 to 2010 were collected retrospectively.All the specific causes of death were classified according to the Cause of Death (CoDe) project protocol.Univariate analysis and multivariate logistic regression analysis were used to find the association between some categorical variables and the risk for AIDS patients died from AIDS related illnesses.Results Clinical characteristics and the cause of death of the 381 deceased in seven hospitals in this study were collected.82.4％ were male,with priority as 30-45 years old.123 (32.3％) death patients had received ART before death.In all death cases,the cause of death of 252 patients (66.1％) were due to AIDS related diseases,with opportunistic infections the most (92.4％).Tubercle bacillus,infection of Penicillium marneffei and Pneumocystis firovecy were the three leading causes of opportunistic infection deaths.Of 129 patients who died of non-AIDS related disease,non-AIDS infection(29.5％),hepatitis (22.5％),and non-AIDS malignancy(10.1％) were the first three causes of death.The cause of death in patients who had injecting drug use behavior within one year,had not receivied ART or not long enough,with opportunistic infections,without hepatitis,with the last low CD4 cell counts before death etc.were tend to due to AIDS related disease.Conclusion Opportunistic infections,non-AIDS related infections and hepatitis were the three leading causes of death in this study.The duration of time on ART had impact on the patient' s cause of death.The HIV infected patients who had received ART before death had more risk to die of non-AIDS related disease,compared to patients who had not.The longer time they had accessed to ART,the less likely they would die on non-AIDS related illnesses.