中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
Chinese Journal of Preventive Medicine
2015年
11期
967-972
,共6页
张广%龚煜汉%王启兴%张石则%廖强%余刚%王科%王菊%叶少东
張廣%龔煜漢%王啟興%張石則%廖彊%餘剛%王科%王菊%葉少東
장엄%공욱한%왕계흥%장석칙%료강%여강%왕과%왕국%협소동
HIV%存活率%抗病毒治疗
HIV%存活率%抗病毒治療
HIV%존활솔%항병독치료
HIV%Survival rate%Antiretroviral therapy
目的 调查四川省凉山彝族自治州(凉山州)首次接受抗病毒治疗成年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对中国艾滋病抗病毒治疗信息管理系统中2005-2013年凉山州18岁以上、首次接受艾滋病抗病毒治疗患者的数据资料进行生存分析,采用Cox比例回归风险模型分析研究对象生存时间的影响因素.结果 8 310例研究对象年龄为(34.59±9.10)岁,经静脉吸毒感染占65.50％(5 443例);从确认HIV抗体阳性到接受抗病毒治疗的时间为(24.68±21.69)个月.436例死于艾滋病相关疾病的研究对象中,28.67％(125例)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年的累积生存率分别为97.11％、93.41％、90.61％、88.81％、86.02％.Cox比例风险回归模型分析结果显示,男性艾滋病患者病死的风险高于女性(HR=1.57,95％CI:1.13～2.18);静脉吸毒感染艾滋病的患者病死的风险高于异性性传播感染者(HR=1.64,95％CI:1.20～2.24);治疗前最近1年患肺结核的艾滋病患者病死的风险高于无肺结核的患者(HR=1.52,95％CI: 1.05～2.21);在治疗前3个月有艾滋病相关疾病或出现过相关症状的艾滋病患者病死的风险高于未出现的相关疾病或出现过相关症状的艾滋病患者(HR=1.80,95％CI:1.39～2.34);首次CD4+T淋巴细胞计数检测结果＜50个/μl(HR=9.79,95％ CI:6.03～15.89)、50～199个/μl(HR=3.26,95％CI:2.32～4.59)、200～349个/μl(HR=1.69,95％CI:1.22～2.34)的患者病死的风险均高于≥350个/μl的患者.结论 四川省凉山州艾滋病患者接受抗病毒治疗后累积生存率较高;男性、最近1年患肺结核、静脉吸毒感染、治疗前3个月有艾滋病相关疾病或出现过相关症状、首次CD4+T淋巴细胞计数较低的艾滋病患者死亡风险较高.
目的 調查四川省涼山彝族自治州(涼山州)首次接受抗病毒治療成年艾滋病患者的生存時間及其影響因素.方法 運用迴顧性隊列研究方法對中國艾滋病抗病毒治療信息管理繫統中2005-2013年涼山州18歲以上、首次接受艾滋病抗病毒治療患者的數據資料進行生存分析,採用Cox比例迴歸風險模型分析研究對象生存時間的影響因素.結果 8 310例研究對象年齡為(34.59±9.10)歲,經靜脈吸毒感染佔65.50％(5 443例);從確認HIV抗體暘性到接受抗病毒治療的時間為(24.68±21.69)箇月.436例死于艾滋病相關疾病的研究對象中,28.67％(125例)是在治療開始後的6箇月內病死.接受抗病毒治療第1、2、3、4、5年的纍積生存率分彆為97.11％、93.41％、90.61％、88.81％、86.02％.Cox比例風險迴歸模型分析結果顯示,男性艾滋病患者病死的風險高于女性(HR=1.57,95％CI:1.13～2.18);靜脈吸毒感染艾滋病的患者病死的風險高于異性性傳播感染者(HR=1.64,95％CI:1.20～2.24);治療前最近1年患肺結覈的艾滋病患者病死的風險高于無肺結覈的患者(HR=1.52,95％CI: 1.05～2.21);在治療前3箇月有艾滋病相關疾病或齣現過相關癥狀的艾滋病患者病死的風險高于未齣現的相關疾病或齣現過相關癥狀的艾滋病患者(HR=1.80,95％CI:1.39～2.34);首次CD4+T淋巴細胞計數檢測結果＜50箇/μl(HR=9.79,95％ CI:6.03～15.89)、50～199箇/μl(HR=3.26,95％CI:2.32～4.59)、200～349箇/μl(HR=1.69,95％CI:1.22～2.34)的患者病死的風險均高于≥350箇/μl的患者.結論 四川省涼山州艾滋病患者接受抗病毒治療後纍積生存率較高;男性、最近1年患肺結覈、靜脈吸毒感染、治療前3箇月有艾滋病相關疾病或齣現過相關癥狀、首次CD4+T淋巴細胞計數較低的艾滋病患者死亡風險較高.
목적 조사사천성량산이족자치주(량산주)수차접수항병독치료성년애자병환자적생존시간급기영향인소.방법 운용회고성대렬연구방법대중국애자병항병독치료신식관리계통중2005-2013년량산주18세이상、수차접수애자병항병독치료환자적수거자료진행생존분석,채용Cox비례회귀풍험모형분석연구대상생존시간적영향인소.결과 8 310례연구대상년령위(34.59±9.10)세,경정맥흡독감염점65.50％(5 443례);종학인HIV항체양성도접수항병독치료적시간위(24.68±21.69)개월.436례사우애자병상관질병적연구대상중,28.67％(125례)시재치료개시후적6개월내병사.접수항병독치료제1、2、3、4、5년적루적생존솔분별위97.11％、93.41％、90.61％、88.81％、86.02％.Cox비례풍험회귀모형분석결과현시,남성애자병환자병사적풍험고우녀성(HR=1.57,95％CI:1.13～2.18);정맥흡독감염애자병적환자병사적풍험고우이성성전파감염자(HR=1.64,95％CI:1.20～2.24);치료전최근1년환폐결핵적애자병환자병사적풍험고우무폐결핵적환자(HR=1.52,95％CI: 1.05～2.21);재치료전3개월유애자병상관질병혹출현과상관증상적애자병환자병사적풍험고우미출현적상관질병혹출현과상관증상적애자병환자(HR=1.80,95％CI:1.39～2.34);수차CD4+T림파세포계수검측결과＜50개/μl(HR=9.79,95％ CI:6.03～15.89)、50～199개/μl(HR=3.26,95％CI:2.32～4.59)、200～349개/μl(HR=1.69,95％CI:1.22～2.34)적환자병사적풍험균고우≥350개/μl적환자.결론 사천성량산주애자병환자접수항병독치료후루적생존솔교고;남성、최근1년환폐결핵、정맥흡독감염、치료전3개월유애자병상관질병혹출현과상관증상、수차CD4+T림파세포계수교저적애자병환자사망풍험교고.
Objective To investigate the survival time and its impact factors among AIDS patients who initially received antiretroviral treatment (ART) of Liangshan Yi Autonomous Prefecture,Sichuan province.Methods A retrospective cohort study was conducted to analyze the information of AIDS patients over 18 years old initially received ART in Liangshan Yi Autonomous Prefecture during 2005-2013, which were downloaded from Chinese AIDS Antiretroviral Therapy DATA Fax Information System.Cox proportion hazard regression model was used to identify impact factors related survival time.Results Among 8 310 ART AIDS patients who initially received ART, their mean age was (34.59±9.10) years old, 65.50％ (5 443cases) were infected with HIV through injecting drug use, the mean time from testing HIV positive to starting ART were (24.68±21.69) months.436 cases died of AIDS related diseases, 28.67％ (125 cases) of them died within the first 6 months of treatment.The cumulative survival rate of receiving ART in 1,2,3,4 5 years were 97.11％, 93.41％, 90.61％, 88.81％, 86.02％, respectively.Multivariate Cox regression analysis showed the male patients receiveing ART were at a higher risk death of AIDS related diseases compared to the females (HR=1.57,95％CI:1.13-2.182), the patients infected with HIV through injecting drug use were at a higher risk deathcompared to the infected through heterosexual transmission (HR=1.64, 95％ CI:1.20-2.24),before the treatment patients with tuberculosis in recent1 year had higher death hazard as compared to those without tuberculosis (HR=1.53,95％CI:1.05-2.21), in the treatment of the first 3 months of AIDS related diseases or symptoms of AIDS patients had higher death hazard as compared to those not suffer these diseases(HR=1.80,95％ CI:1.39-2.34).The patients with baseline CD4-T lymphocytes cell counts ＜50/μl(HR=9.79,95％ CI:6.03-15.89), 50-199/μl (HR=3.26,95％ CI:2.32-4.59), 200-349/μl (HR=1.69,95％ CI:1.22-2.34),were at a higher risk death than those with CD4 +T lymphocytes cell counts ≥350/μl.Conclusion Accumulate survival rate was higher after initial antiretroviral treatment among AIDS patients in Liangshan Yi Autonomous Prefecture, Sichuan province.AIDS patients who are males, have tuberculosis in recent year, infected HIV via route of intravenous drug use, with AIDS-related illness or symptoms in 3 months before ART, lower baseline CD4+T lymphocyte count have higher risk of death.
