中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2014年
11期
953-958
,共6页
倪明健%陈学玲%胡晓远%马媛媛
倪明健%陳學玲%鬍曉遠%馬媛媛
예명건%진학령%호효원%마원원
获得性免疫缺陷综合征%死亡率%抗逆转录病毒治疗,高效%生存分析
穫得性免疫缺陷綜閤徵%死亡率%抗逆轉錄病毒治療,高效%生存分析
획득성면역결함종합정%사망솔%항역전록병독치료,고효%생존분석
Acquired immunodeficiency syndrome%Mortality%Antiretroviral therapy,high active%Survival analysis
目的:调查新疆维吾尔自治区(简称新疆自治区)艾滋病高效抗病毒治疗( HAART)者的死亡情况,并分析其影响因素。方法以新疆自治区符合艾滋病HAART的HIV感染者及艾滋病患者为研究对象,对其进行HAART。 HAART的所有过程资料及时上传至国家“艾滋病综合防治信息系统”中的“抗病毒治疗信息系统”。采用回顾性分析研究方法,分析新疆自治区2004年7月至2013年6月14062例HAART者的死亡率和累积生存率,并采用Cox 回归模型分析死亡的影响因素。结果随访期间,死亡对象占8畅5%(1200/14062),失访率为2畅5%(351/14062),转诊至外省者占0畅9%(121/14062),停药者占15畅4%(2162/14062)。基线CD4+T淋巴细胞水平的P25、P50、P75分别为144畅00、244畅50、331畅00个/μl。 HAART者死亡率为4畅98/100人年,治疗后1~5年生存率分别为0畅94、0畅91、0畅88、0畅84、0畅81。男性死亡率(6畅58/100人年)高于女性(2畅87/100人年),感染结核组死亡率(9畅79/100人年)高于未感染组(4畅12/100人年),基线CD4+T淋巴细胞<200个/μl组死亡率组内较高,为7畅67/100人年,吸毒传播组死亡率(7畅61/100人年)高于性行为传播组(3畅10/100人年),基线血红蛋白<80 g/L组死亡率(13畅84/100人年)高于≥80 g/L组(4畅74/100人年);χ2值分别为154畅62、177畅47、309畅73、228畅99、84畅27,P值均<0畅01。基线CD4+T淋巴细胞<200个/μl者死亡风险是>350个/μl者的3畅61(2畅73~4畅78)倍,出现≥4种临床症状者死亡风险是无症状者的3畅62(2畅42~5畅42)倍,基线血红蛋白<80 g/L者死亡风险是≥80 g/L者的2畅84(2畅21~3畅64)倍,男性死亡风险是女性的1畅48(1畅25~1畅75)倍,感染结核者死亡风险是未感染者的1畅39(1畅18~1畅64)倍,吸毒传播者死亡风险是性传播者的1畅84(1畅56~2畅17)倍。结论2004—2013年,新疆自治区HIV感染者HAART后的死亡率较低;基线CD4+T淋巴细胞水平较低、治疗前出现临床症状较多、血红蛋白较低、吸毒传播、男性、感染肺结核是死亡的主要影响因素。
目的:調查新疆維吾爾自治區(簡稱新疆自治區)艾滋病高效抗病毒治療( HAART)者的死亡情況,併分析其影響因素。方法以新疆自治區符閤艾滋病HAART的HIV感染者及艾滋病患者為研究對象,對其進行HAART。 HAART的所有過程資料及時上傳至國傢“艾滋病綜閤防治信息繫統”中的“抗病毒治療信息繫統”。採用迴顧性分析研究方法,分析新疆自治區2004年7月至2013年6月14062例HAART者的死亡率和纍積生存率,併採用Cox 迴歸模型分析死亡的影響因素。結果隨訪期間,死亡對象佔8暢5%(1200/14062),失訪率為2暢5%(351/14062),轉診至外省者佔0暢9%(121/14062),停藥者佔15暢4%(2162/14062)。基線CD4+T淋巴細胞水平的P25、P50、P75分彆為144暢00、244暢50、331暢00箇/μl。 HAART者死亡率為4暢98/100人年,治療後1~5年生存率分彆為0暢94、0暢91、0暢88、0暢84、0暢81。男性死亡率(6暢58/100人年)高于女性(2暢87/100人年),感染結覈組死亡率(9暢79/100人年)高于未感染組(4暢12/100人年),基線CD4+T淋巴細胞<200箇/μl組死亡率組內較高,為7暢67/100人年,吸毒傳播組死亡率(7暢61/100人年)高于性行為傳播組(3暢10/100人年),基線血紅蛋白<80 g/L組死亡率(13暢84/100人年)高于≥80 g/L組(4暢74/100人年);χ2值分彆為154暢62、177暢47、309暢73、228暢99、84暢27,P值均<0暢01。基線CD4+T淋巴細胞<200箇/μl者死亡風險是>350箇/μl者的3暢61(2暢73~4暢78)倍,齣現≥4種臨床癥狀者死亡風險是無癥狀者的3暢62(2暢42~5暢42)倍,基線血紅蛋白<80 g/L者死亡風險是≥80 g/L者的2暢84(2暢21~3暢64)倍,男性死亡風險是女性的1暢48(1暢25~1暢75)倍,感染結覈者死亡風險是未感染者的1暢39(1暢18~1暢64)倍,吸毒傳播者死亡風險是性傳播者的1暢84(1暢56~2暢17)倍。結論2004—2013年,新疆自治區HIV感染者HAART後的死亡率較低;基線CD4+T淋巴細胞水平較低、治療前齣現臨床癥狀較多、血紅蛋白較低、吸毒傳播、男性、感染肺結覈是死亡的主要影響因素。
목적:조사신강유오이자치구(간칭신강자치구)애자병고효항병독치료( HAART)자적사망정황,병분석기영향인소。방법이신강자치구부합애자병HAART적HIV감염자급애자병환자위연구대상,대기진행HAART。 HAART적소유과정자료급시상전지국가“애자병종합방치신식계통”중적“항병독치료신식계통”。채용회고성분석연구방법,분석신강자치구2004년7월지2013년6월14062례HAART자적사망솔화루적생존솔,병채용Cox 회귀모형분석사망적영향인소。결과수방기간,사망대상점8창5%(1200/14062),실방솔위2창5%(351/14062),전진지외성자점0창9%(121/14062),정약자점15창4%(2162/14062)。기선CD4+T림파세포수평적P25、P50、P75분별위144창00、244창50、331창00개/μl。 HAART자사망솔위4창98/100인년,치료후1~5년생존솔분별위0창94、0창91、0창88、0창84、0창81。남성사망솔(6창58/100인년)고우녀성(2창87/100인년),감염결핵조사망솔(9창79/100인년)고우미감염조(4창12/100인년),기선CD4+T림파세포<200개/μl조사망솔조내교고,위7창67/100인년,흡독전파조사망솔(7창61/100인년)고우성행위전파조(3창10/100인년),기선혈홍단백<80 g/L조사망솔(13창84/100인년)고우≥80 g/L조(4창74/100인년);χ2치분별위154창62、177창47、309창73、228창99、84창27,P치균<0창01。기선CD4+T림파세포<200개/μl자사망풍험시>350개/μl자적3창61(2창73~4창78)배,출현≥4충림상증상자사망풍험시무증상자적3창62(2창42~5창42)배,기선혈홍단백<80 g/L자사망풍험시≥80 g/L자적2창84(2창21~3창64)배,남성사망풍험시녀성적1창48(1창25~1창75)배,감염결핵자사망풍험시미감염자적1창39(1창18~1창64)배,흡독전파자사망풍험시성전파자적1창84(1창56~2창17)배。결론2004—2013년,신강자치구HIV감염자HAART후적사망솔교저;기선CD4+T림파세포수평교저、치료전출현림상증상교다、혈홍단백교저、흡독전파、남성、감염폐결핵시사망적주요영향인소。
Objective To analyze the mortality and risk factors among HIV/AIDS patients receiving highly active antiretroviral therapy ( HAART ) in the Xinjiang Uyghur Autonomous Region ( XUAR ).Methods The objects of study were all HIV/AIDS adult patients who had received HAART in XUAR.The proceeding information was uploaded to the national ART reporting system which was a branch of the national HIV/AIDS reporting system.A retrospective cohort study was conducted among these patients who were treated during July 2004 to June 2013 in XUAR.Mortality rates and cumulative survival rates were calculated.Cox proportional hazard model was conducted to examine the risk factors for deaths .Results The proportion for death, lost, referral and withdrawal were 8.5%(1 200/14 062),2.5%(351/14 062), 0.9%(121/14 062) and 15.4%(2 162/14 062) respectively.The P25,P50 and P75 of baseline CD4 +T lymphocyte was 144.00, 244.50 and 331.00/μl, respectively.The overall mortality rate was 4.98/100 person-years.The cumulative survival rate of ART treatment after 1-5 years were 0.94,0.91,0.88,0.84 and 0.81.The mortality rate had a significant difference among different population .The male ( 6.58/100 person-years) was higher than the female (2.87/100 person-years), the people who infected tuberculosis (TB) (9.79/100 person-years) was higher than those non TB (4.12/100 person-years),the people whose CD4 +T lymphocyte count less than 200/μl ( 7.67/100 person-years ) was higher than other groups , the people who were transmitted through injection ( 7.61/100 person-years ) was higher than those sexual transmission (3.10/100 person-years),the people whose HB less than 80 g/L (13.84/100 person-years) was higher than those more than 80 g/L(4.74/100 person-years)(χ2 values were 154.62,177.47,309.73, 228.99 and 84.27.P<0.01).The risk of death of the one with the baseline CD 4 +T lymphocyte≤200/μl was 3.61(2.73-4.78) times of the one with the baseline CD 4 +T lymphocyte >350/μl.The risk of death of the one having more than 4 baseline symptom categories was 3.62(2.42-5.42) times of the one having less than 3 baseline symptom categories.The risk of death of the one with baseline HB ≥80 g/L was 2.84(2.21-3.64) times of the one with the baseline HB <80 g/L.The risk of death of the male was 1.48(1.25-1.75) times of the female.The risk of death of the one infected TB was 1.39 ( 1.18-1.64 ) times of the one not infected TB.The risk of death of the one injecting drugs was 1.84(1.56-2.17) times of the one not injecting drugs.Conclusion From 2004 to 2013, the mortality rate was low among HIV/AIDS patients receiving ART in XUAR.The mortality risk factors were low CD4 T cell count, having more baseline symptom categories, low HB level, injection drug transmission, male and TB infection, all these factors had positive correlation with death .