中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2013年
11期
1010-1013
,共4页
曾刚%吕繁%罗夏%周啟芳%刘伟%黄爱林%吴尊友
曾剛%呂繁%囉夏%週啟芳%劉偉%黃愛林%吳尊友
증강%려번%라하%주계방%류위%황애림%오존우
获得性免疫缺陷综合征%HIV感染%门诊部,医院%筛查%效果
穫得性免疫缺陷綜閤徵%HIV感染%門診部,醫院%篩查%效果
획득성면역결함종합정%HIV감염%문진부,의원%사사%효과
Acquired immunodeficiency syndrome%HIV infections%Outpatient clinics,hospital%Screening%Effectiveness
目的 比较在门诊患者中实施病症筛查和抽血患者全员筛查策略在促进HIV感染者多发现、早发现方面的效果.方法 于2011年7-11月,采用流行病学类实验设计方法,在广西壮族自治区选取艾滋病流行水平、人口和医疗资源均相近的L县和J县的县医院门诊部为研究现场,分别实施HIV病症筛查策略和抽血患者全员筛查策略,并选取两所医院15岁以上的就诊患者为研究对象,分别为62 106和58 057人次.在实施策略期间,收集两所医院各科室门诊逐月就诊人次数,通过医院HIV筛查实验室检测记录获取不同科室患者检测情况、初筛阳性结果.采用x2检验比较两种策略在新发现HIV阳性者比例、HIV阳性检出率和HIV阳性者早期感染等指标上的差异.结果 实施抽血患者全员筛查策略的J县县医院和实施病症筛查策略的L县县医院门诊患者中,接受HIV检测的比例分别为9.69％ (527/58 057)和1.38％(859/62 106)；年龄分别为(46.23±16.81)、(40.75±15.48)岁,差异有统计学意义(t=8.81,P＜0.05)；J县县医院新发现HIV阳性者比例[0.03％(19/58 057)]高于L县[0.02％(10/62 106)](P＜0.05),而J县县医院HIV阳性检出率[0.34％(19/5627)]低于L县[1.16％ (10/859)](x2=9.66,P＜0.05).结论 医疗机构实施抽血患者全员筛查策略相对病症筛查策略可以发现更多HIV感染者.
目的 比較在門診患者中實施病癥篩查和抽血患者全員篩查策略在促進HIV感染者多髮現、早髮現方麵的效果.方法 于2011年7-11月,採用流行病學類實驗設計方法,在廣西壯族自治區選取艾滋病流行水平、人口和醫療資源均相近的L縣和J縣的縣醫院門診部為研究現場,分彆實施HIV病癥篩查策略和抽血患者全員篩查策略,併選取兩所醫院15歲以上的就診患者為研究對象,分彆為62 106和58 057人次.在實施策略期間,收集兩所醫院各科室門診逐月就診人次數,通過醫院HIV篩查實驗室檢測記錄穫取不同科室患者檢測情況、初篩暘性結果.採用x2檢驗比較兩種策略在新髮現HIV暘性者比例、HIV暘性檢齣率和HIV暘性者早期感染等指標上的差異.結果 實施抽血患者全員篩查策略的J縣縣醫院和實施病癥篩查策略的L縣縣醫院門診患者中,接受HIV檢測的比例分彆為9.69％ (527/58 057)和1.38％(859/62 106)；年齡分彆為(46.23±16.81)、(40.75±15.48)歲,差異有統計學意義(t=8.81,P＜0.05)；J縣縣醫院新髮現HIV暘性者比例[0.03％(19/58 057)]高于L縣[0.02％(10/62 106)](P＜0.05),而J縣縣醫院HIV暘性檢齣率[0.34％(19/5627)]低于L縣[1.16％ (10/859)](x2=9.66,P＜0.05).結論 醫療機構實施抽血患者全員篩查策略相對病癥篩查策略可以髮現更多HIV感染者.
목적 비교재문진환자중실시병증사사화추혈환자전원사사책략재촉진HIV감염자다발현、조발현방면적효과.방법 우2011년7-11월,채용류행병학류실험설계방법,재엄서장족자치구선취애자병류행수평、인구화의료자원균상근적L현화J현적현의원문진부위연구현장,분별실시HIV병증사사책략화추혈환자전원사사책략,병선취량소의원15세이상적취진환자위연구대상,분별위62 106화58 057인차.재실시책략기간,수집량소의원각과실문진축월취진인차수,통과의원HIV사사실험실검측기록획취불동과실환자검측정황、초사양성결과.채용x2검험비교량충책략재신발현HIV양성자비례、HIV양성검출솔화HIV양성자조기감염등지표상적차이.결과 실시추혈환자전원사사책략적J현현의원화실시병증사사책략적L현현의원문진환자중,접수HIV검측적비례분별위9.69％ (527/58 057)화1.38％(859/62 106)；년령분별위(46.23±16.81)、(40.75±15.48)세,차이유통계학의의(t=8.81,P＜0.05)；J현현의원신발현HIV양성자비례[0.03％(19/58 057)]고우L현[0.02％(10/62 106)](P＜0.05),이J현현의원HIV양성검출솔[0.34％(19/5627)]저우L현[1.16％ (10/859)](x2=9.66,P＜0.05).결론 의료궤구실시추혈환자전원사사책략상대병증사사책략가이발현경다HIV감염자.
Objective To determine whether non-targeted testing strategy (screening all patients with blood sample withdrawn) could identify more patients with newly diagnosed HIV infection than symptom and risk behavior based targeted testing strategy or not.Methods Controlled trial design was applied in this study.From July to November 2011,outpatient department of L and J county hospital in Guangxi province were selected to conduct the targeted strategy and non-targeted strategy respectively.The two counties had similar population,outpatient volume,previous testing rate and number of newly identified HIV cases.Outpatients older than 15 years were recruited as study subjects,with 62 106 person time in L hospital and 58 257 in J hospital.Data about visit number,persons receiving HIV testing and HIV positive cases were collected by outpatient department.Chi-square test was used to compare the percentage of newly identified HIV cases,HIV positive detection rate and proportion of cases in early AIDS phase between two strategies.Results During the study period,9.69％ (5627/58057) of all outpatients in J hospital with non-targeted strategy and 1.38％ (859/62106) of all outpatients in L hospital with targeted strategy received HIV test.The average age of patients receiving HIV testing was 46.23 _± 16.81 and 40.75 ± 15.48respectively,which was statistically different (t =8.81,P ＜ 0.05).The percentage of newly identified HIV cases was significantly greater in J hospital (0.03％ (19/58057)) than that in L hospital (0.02％(10/62106)) (P ＜ 0.05) while the HIV positive detection rate was lower in J hospital (0.34％ (19/5627))than that in L hospital (1.16％ (10/859)) (x2 =9.66,P ＜ 0.05).Conclusion In a concentrated epidemic,a hospital based non-targeted strategy could detect more unidentified HIV cases than targeted strategy.
