CAJ | 학술논문

目的比较不同时间开始抗病毒治疗对艾滋病患者生存状况的影响,并探讨抗病毒治疗最佳时机.方法利用国家艾滋病抗病毒治疗信息系统,收集2007-2012年河南省加入抗病毒治疗的艾滋病患者基本和随访信息,并按照基线免疫学水平,将所有研究对象分为早期治疗组(基线CD4+T淋巴细胞计数350～500 cell/μl)和常规治疗组(基线CD4+T淋巴细胞计数≤350 cell/μl),采用生存分析方法进行全死因回顾分析.结果共纳入16 282例艾滋病患者,常规治疗组病死率明显高于早期治疗组(5.78/100人年vs.1.64/100人年),中位生存期低于早期治疗组中位生存期(2.07年vs.3.15年).常规治疗组6年累积生存率低于早期治疗组(77.39％vs.92.10％,x2=156.00,P＜0.01).多因素分析显示,开始治疗时年龄、性别、婚姻状况、感染途径、初始治疗方案和基线症状数为常规治疗组生存时间的影响因素(P＜0.05),开始治疗时的性别、初始治疗方案和基线症状数为早期治疗组生存时间的影响因素(P＜0.05).结论早期抗病毒治疗可提高河南省接受抗病毒治疗的艾滋病患者生存率,延长其生存时间.
목적 비교불동시간개시항병독치료대애자병환자생존상황적영향,병탐토항병독치료최가시궤.방법 이용국가애자병항병독치료신식계통,수집2007-2012년하남성가입항병독치료적애자병환자기본화수방신식,병안조기선면역학수평,장소유연구대상분위조기치료조(기선CD4+T림파세포계수350～500 cell/μl)화상규치료조(기선CD4+T림파세포계수≤350 cell/μl),채용생존분석방법진행전사인회고분석.결과 공납입16 282례애자병환자,상규치료조병사솔명현고우조기치료조(5.78/100인년vs.1.64/100인년),중위생존기저우조기치료조중위생존기(2.07년vs.3.15년).상규치료조6년루적생존솔저우조기치료조(77.39％vs.92.10％,x2=156.00,P＜0.01).다인소분석현시,개시치료시년령、성별、혼인상황、감염도경、초시치료방안화기선증상수위상규치료조생존시간적영향인소(P＜0.05),개시치료시적성별、초시치료방안화기선증상수위조기치료조생존시간적영향인소(P＜0.05).결론 조기항병독치료가제고하남성접수항병독치료적애자병환자생존솔,연장기생존시간.
Objective To compare the survival effect of initiation of antiretroviral treatment on AIDS patients at different stages so as to explore the best time of initiation with the treatment.Methods Information regarding the dates of AIDS patient initially receiving the anti-retroviral therapy during 2007-2012 was collected from the Chinese HIV/AIDS Integrated Control System.According to the level of baseline immunology,all the participants were divided into earlier treatment group (baseline CD4+T cell counts between 350/ μl and 500/μl) and conventional treatment group (baseline CD4+T cell counts ≤350/ μl).Data was analyzed under Survival and Review methods.Results A total number of 16 282 cases were selected.The mortality of conventional treatment group was obviously higher than the earlier treatment group (5.78/100 person year vs.1.64/100 person year),and the median survival time was lower than the earlier treatment group (2.07 year vs.3.15 year).The cumulative survival rate of the 6-year conventional treatment group was lower than the earlier treatment group (77.39％ vs.92.10％,x2=156.00,P ＜ 0.01).By means of multi-variable analysis,we found that factors as age,gender,marital status,route of transmission,schedule on initial therapy,number of symptoms at the baseline etc.in the conventional treatment group were associated with survival time of patients after the ART initiation (P＜0.05),while gender,schedule for initial therapy,number of symptoms at baseline etc.in the earlier treatment group,were associated with survival time of patients after the initiation of ART (P＜0.05).Conclusion Earlier initiation of antiretroviral treatment on AIDS patients could improve the survival rate and prolong the survival time.