CAJ | 학술논문

目的分析四川省凉山州首次接受抗病毒治疗艾滋病患者的生存时间及其影响因素.方法运用回顾性队列研究方法,分析2004-2012年中国艾滋病抗病毒治疗信息管理系统中的凉山州艾滋病患者资料,应用寿命表法计算生存率,采用Cox比例风险模型分析生存时间的影响因素.结果 5 525例研究对象平均年龄(34.5±9.0)岁,男性占73.9％,经静脉吸毒感染占65.8％;从确认HIV抗体阳性到接受抗病毒治疗平均时间为(23.0±20.1)个月.死于艾滋病相关疾病的287例治疗平均时间为(12.7±10.6)个月,其中32.8％是在治疗开始后的6个月内病死.接受抗病毒治疗第1、2、3、4、5年的生存率分别为97％、93％、89％、88％、84％.Cox比例风险回归模型分析显示,女性艾滋病患者病死的风险低于男性(HR=0.556,95％CI:0.367 ～ 0.872);静脉吸毒感染艾滋病的患者病死风险高于异性性传播感染(HR=1.569,95％CI:1.061～2.321);首次CD4+T淋巴细胞计数检测结果＜ 50 cell/mm3(HR=11.996,95％CI:6.714 ～ 21.435)、50 ～ 200 cell/mm3(HR=2.481,95％CI:1.620 ～ 3.798)的患者病死风险均高于≥350 cell/mm3的患者;治疗前最近1年无肺结核的艾滋病患者病死风险低于患有肺结核的患者(HR=0.511,95％CI:0.330～0.791).结论凉山州艾滋病患者接受抗病毒治疗延长了生存时间,提高了生存率;艾滋病患者应定期进行随访和CD4+T淋巴细胞检测,及时接受抗病毒治疗.
목적 분석사천성량산주수차접수항병독치료애자병환자적생존시간급기영향인소.방법 운용회고성대렬연구방법,분석2004-2012년중국애자병항병독치료신식관리계통중적량산주애자병환자자료,응용수명표법계산생존솔,채용Cox비례풍험모형분석생존시간적영향인소.결과 5 525례연구대상평균년령(34.5±9.0)세,남성점73.9％,경정맥흡독감염점65.8％;종학인HIV항체양성도접수항병독치료평균시간위(23.0±20.1)개월.사우애자병상관질병적287례치료평균시간위(12.7±10.6)개월,기중32.8％시재치료개시후적6개월내병사.접수항병독치료제1、2、3、4、5년적생존솔분별위97％、93％、89％、88％、84％.Cox비례풍험회귀모형분석현시,녀성애자병환자병사적풍험저우남성(HR=0.556,95％CI:0.367 ～ 0.872);정맥흡독감염애자병적환자병사풍험고우이성성전파감염(HR=1.569,95％CI:1.061～2.321);수차CD4+T림파세포계수검측결과＜ 50 cell/mm3(HR=11.996,95％CI:6.714 ～ 21.435)、50 ～ 200 cell/mm3(HR=2.481,95％CI:1.620 ～ 3.798)적환자병사풍험균고우≥350 cell/mm3적환자;치료전최근1년무폐결핵적애자병환자병사풍험저우환유폐결핵적환자(HR=0.511,95％CI:0.330～0.791).결론 량산주애자병환자접수항병독치료연장료생존시간,제고료생존솔;애자병환자응정기진행수방화CD4+T림파세포검측,급시접수항병독치료.
Objective To analyze the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) in Liangshan prefecture during 2004-2012.Methods A retrospective cohort study was conducted to analyze the information of AIDS patients who initially received ART.Data on patients was collected from the Chinese AIDS Antiretroviral Therapy DATAFax Information System.Life table was applied to calculate the survival proportion,and Cox proportion hazard regression model was used to identify impact factors that were related to the time of survival.Results Among 5 525 AIDS patients who initially received ART,the median age was (34.5±9.0) year old,with 73.9％ being males,65.8％ were infected through injecting drug use,time from HIV tested HIV positive to starting ART was (23.0 ± 20.1) months.287 cases died of AIDS related diseases,and their median time of receiving ART was (12.7 ± 10.6) months,and 32.8％ of them died within the first 6 months of treatment.Cumulative survival rates of the patients who had received ART in 1,2,3,4,5 years were 97％,93％,89％,88％,84％,respectively.Results from multivariate Cox regression showed that female patients who received ART were at a lower risk to the death of AIDS related diseases (HR=0.556,95％CI:0.367-0.872),when compared to the males.Patients infected with HIV through injecting drug use were at a higher risk to death (HR=1.569,95％ CI:1.061-2.321) when compared to those who were infected through heterosexual transmission.Patients with baseline CD4 +T cells counts at ＜50 cells/mm3 (HR=11.996,95％ CI:6.714-21.435) or 50-200 cells/mm3(HR=2.481,95％CI:1.620-3.798)were at a higher risk to death than those with CD4+T cell counts ≥350 cells/mm3.Patients without pulmonary tuberculosis were at a lower risk to death (HR=0.511,95％ CI:0.330-0.791)when compared to those with pulmonary tuberculosis a year before starting the treatment.Conclusion Antiretroviral treatment could prolong the survival time of AIDS patients and with a better rate on survival.Programs on follow-up and CD4 + T cell counts for AIDS patients should be conducted regularly,as well as timely initiated the antiretroviral therapy.