乌鲁木齐市4445例艾滋病患者抗病毒治疗后生存分析  

Survival analysis on 4445 AIDS patients receiving antiretroviral treatment in Urumqi

作　　者：王云霞[1] 张曼[1] 李翔[1] 马燕[1] 米娜瓦尔[1] 孙磊[1] 芮宝玲[1] 

机构地区：[1]乌鲁木齐市疾病预防控制中心

出　　处：《现代预防医学》2015年第8期1512-1515,共4页Modern Preventive Medicine

摘　　要：目的了解乌鲁木齐市艾滋病患者接受抗病毒治疗后的生存状况及影响患者治疗后生存时间的因素。方法利用国家成年人DATAFAX抗病毒治疗信息系统,收集2004-2013年全市抗病毒治疗者的生存、死亡信息,采用COX比例风险回归模型对影响艾滋病患者抗病毒治疗生存时间的因素进行分析。结果共收集4 445例有效接受抗病毒治疗的艾滋病患者的人口学信息、治疗前体检信息等,其中存活4 159例,死亡286例。艾滋病患者总体的病死率为3.16/100人年。艾滋病患者CD4＋T淋巴细胞计数水平不同、基线血红蛋白不同、婚姻状况不同、感染途径不同,生存曲线差异有统计学意义。多因素Cox回归分析显示,影响艾滋病患者生存时间的危险因素是：基线CD4＋T淋巴细胞低（RR=1.280;95%CI：1.157-1.403）、血红蛋白〈90 g/L的中度贫血（RR=1.561;95%CI：1.343-1.779）,其他影响艾滋病治疗者生存时间的危险因素为注射或吸毒传播;影响艾滋病患者治疗后生存时间的保护因素为已婚或者同居。结论乌鲁木齐市艾滋病免费抗病毒治疗降低了艾滋病死亡率,延长了患者的生存时间;提高抗病毒治疗时艾滋病患者的CD4＋T淋巴细胞水平并获得家庭的支持,及时开展艾滋病的抗病毒治疗。Objective The aim of this study was to study the effect of a government-provided-free highly active antiretroviral treatment（HAART） program, on the reduction of mortality and relevant risk factors among AIDS patients（adult） in Urumqi city.Methods Data on the survival and death of AIDS patients were collected from the national HAART reporting system between 2004 and 2013. Cox proportional hazards model was applied to analyze those factors affecting the survival time of the patients. Results Four thousand four hundred and forty-five cases were enrolled in this study in Urumqi city, from 2004 to 2013. The overall mortality were 3.16/100 person-years. There was significant difference between the survival curves of different CD4＋T counts, different hemoglobin numbers, different marital status and different routes of transmission. Results from the multivariate Cox proportional hazards regression analysis indicated that CD4＋T cell counts（RR=1.280; 95% CI：1.157-1.403） was a risk factor causing death. Hb of the patients that was lower than 90 was a risk factor causing death（RR=1.561; 95% CI：1.343-1.779）. In addition, other risk factors including IDUs would lead to death. However,the protective factors included married or live together, and it seemed helpful for the other spouse to live longer. Conclusion In Urumqi, the national free treatment program had significantly reduced the AIDS mortality rate. Some effective measures should be further taken to monitor the CD4＋T cells and get support from family. Patients who were in need to take the HARRT should be adopted into the ART timely.

关 键 词：艾滋病 抗病毒治疗 病死率 

分 类 号：R183[医药卫生—流行病学]