云南省德宏州1989-2011年HIV感染者死亡率及其影响因素研究
운남성덕굉주1989-2011년HIV감염자사망솔급기영향인소연구
Study on the mortality and risk factors among HIV-infected individuals during 1989-2011 in Dehong prefecture, Yunnan province
  • 万方数据
    中华流行病学杂志 중화류행병학잡지
    CHINESE JOURNAL OF EPIDEMIOLOGY
    2012年 10期 1026-1030 ,共5页

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    양약성%단송%항려분%협윤화%공투용%양세강%고길%양충길%한문향%리주림%복영성%양건화%조동동%리유미%하납

    艾滋病毒感染者%死亡率%影响因素%回顾性队列研究 艾滋病毒感染者%死亡率%影響因素%迴顧性隊列研究
    애자병독감염자%사망솔%영향인소%회고성대렬연구
    HIV-infected individuals%Mortality%Influencing factors%Retrospective cohort study
    目的 了解1989-2011年云南省德宏州HIV感染者死亡率及其影响因素.方法 以德宏州1989-2011年报告的所有现住址为本地的HIV感染者为研究对象,收集其死亡相关信息,计算死亡率和累积生存率,并应用Cox比例风险回归模型分析死亡的影响因素.结果 共有13 006例HIV感染者纳入分析,男性占73.2％,农民占79.1％,48.7％已婚有配偶,少数民族占64.5％,68.7％为文盲或小学文化程度.研究对象累计观察55 962.30人年,死亡4648人,死亡率为8.31/100人年.死亡率在1990-2004年间总体呈上升趋势,自2005年起开始持续下降.研究对象自报告发现HIV感染至观察期末的平均生存时间为9.48年,其中,接受过抗病毒治疗者的平均生存时间为16.65年,而从未接受过抗病毒治疗者的平均生存时间为7.67年.多因素分析显示抗病毒治疗以及年龄、性别、民族、职业、婚姻状况和文化程度等社会人口学因素显著影响HIV感染者的死亡和生存状态.结论 包括抗病毒治疗在内的艾滋病综合防治措施有效地降低了德宏州HIV感染者的死亡率,今后仍需扩大抗病毒治疗覆盖面,并针对HIV感染者的社会人口学特征加强分类管理和随访,以减少HIV感染者死亡.
    목적 료해1989-2011년운남성덕굉주HIV감염자사망솔급기영향인소.방법 이덕굉주1989-2011년보고적소유현주지위본지적HIV감염자위연구대상,수집기사망상관신식,계산사망솔화루적생존솔,병응용Cox비례풍험회귀모형분석사망적영향인소.결과 공유13 006례HIV감염자납입분석,남성점73.2％,농민점79.1％,48.7％이혼유배우,소수민족점64.5％,68.7％위문맹혹소학문화정도.연구대상루계관찰55 962.30인년,사망4648인,사망솔위8.31/100인년.사망솔재1990-2004년간총체정상승추세,자2005년기개시지속하강.연구대상자보고발현HIV감염지관찰기말적평균생존시간위9.48년,기중,접수과항병독치료자적평균생존시간위16.65년,이종미접수과항병독치료자적평균생존시간위7.67년.다인소분석현시항병독치료이급년령、성별、민족、직업、혼인상황화문화정도등사회인구학인소현저영향HIV감염자적사망화생존상태.결론 포괄항병독치료재내적애자병종합방치조시유효지강저료덕굉주HIV감염자적사망솔,금후잉수확대항병독치료복개면,병침대HIV감염자적사회인구학특정가강분류관리화수방,이감소HIV감염자사망.
    Objective To examine the mortality and risk factors among HIV-infected patients during 1989-2011 in Dehong prefecture,Yunnan province.Methods All HIV-infected patients reported during 1989-2011 in Dehong prefecture who held local residency were included in the study.Mortality rates and cumulative survival rates were calculated.Multiple regression analysis under Cox proportional hazard model was conducted to examine the risk factors for deaths.Results A total of 13 006 HIV-infected patients were included in this study including 73.2％ males,79.1％ peasants and 48.7％ married at the time of reporting.64.5％ of the patients were ethnic minorities,and 68.7％ were illiterate or having received only primary school education.All the patients were followed-up for a total of 55 962.30 person-years with 4648 patients died,with overall mortality rate as 8.31/100person-years.The mortality rate had been increasing from 1990 to 2004 but decreasing since 2005.The average survival time since the identification of HIV infection was 9.48 years overall,and was 16.65 years for those having received antiretroviral treatment (ART) and 7.67 years for those without ART.Data from multiple regression analysis indicated that ART and socio-demographic characteristics such as age,gender,ethnicity,occupation,marital status,education background etc.were significantly associated with death among HIV-infected patients.Conclusion The comprehensive AIDS campaigns including ART had significantly reduced the deaths among HIV-infected patients in Dehong prefecture.More efforts on the scaling up program of ART as well as the enhanced management and follow-up program tailored for HIV-infected patients with different sociodemographic characteristics were needed to further reduce the deaths in the area.
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