四川省西昌市艾滋病抗病毒治疗死亡分析  

Mortality Analysis of AIDS Patients Receiving Highly Active Antiretroviral Treatment in Xichang City,Sichuan Province

作　　者：刘倩萍[1] 张万里[1] 邓丽春 段元会 姚芝梅 高旭东[1] 邓瑾[1] 宋本莉[1] 张恒[3] 梁姝[4] 秦光明[4] 阮玉华[3] 

机构地区：[1]西昌市皮肤病性病防治站,四川西昌615000 [2]凉山州卫生学校 [3]传染病预防控制国家重点实验室 [4]四川省疾病预防控制中心

出　　处：《预防医学情报杂志》2015年第8期595-599,共5页Journal of Preventive Medicine Information

基　　金：西昌市科技计划项目;加拿大国际发展署(104519-010)

摘　　要：目的了解四川省西昌市艾滋病抗病毒治疗患者的病死情况和影响因素。方法使用国家＂艾滋病综合防治信息系统——抗病毒治疗管理＂数据库的基本情况和随访用药表,筛选出2009-2012年西昌市开始参加国家免费抗病毒治疗患者的生存、死亡信息,采用Cox比例风险回归模型对影响抗病毒治疗患者病死率的相关因素进行分析。结果在466例参加抗病毒治疗的艾滋病患者中,年龄中位数为35岁（四分位数间距：29-42岁）,男性占83.9%（391/466）,已婚或同居48.3%（225/466）,静脉吸毒传播52.2%（243/466）,异性性传播43.6%（203/466）,开始抗病毒治疗前CD4＋T淋巴细胞计数中位数为272个/μl（四分位数间距：191-326个/μl）。截至2013-12-31,累计死亡36例,病死率为4.0/1 0 0人年。Cox回归分析结果显示接受抗病毒治疗患者主要的死亡风险是抗病毒治疗前出现艾滋病相关疾病或症状（HR=2.9,95%CI：1.4-5.7）和CD4＋T淋巴细胞计数〈2 0 0个/μl（HR=2.3,9 5%CI：1.1-4.6）。结论四川省西昌市的艾滋病患者开展抗病毒治疗有效地降低病死率,早期及时地开始抗病毒治疗是降低艾滋病病死率的关键。Objective To investigate the mortality status and risk factors among AIDS patients receiving highly active antiretroviral treatment（ HAART） in Xichang city, Sichuan province.Methods Data of survival and death of AIDS patients receiving HAART between 2009 and 2012 in Xichang city, Sichuan province were collected through HAART basic information and follow- up table from national AIDS comprehensive treatment and prevention system. Cox proportional hazard regression model was employed to analyze risk factors. Results Of 466 HAART patients,median age was 35years（ IQR： 29- 42）,83. 9%（ 391 /466） were male and 48. 3%（ 225 /466） were married or cohabitants. A proportion of 43. 6%（ 203 /466） were infected through heterosexual behaviors,52. 2%（ 243 /466） were injecting drug users. The median CD4 count was 272 cells per μL（ IQR： 29- 42） at the initiation of HAART. By the end of 2013,36 cases died,and the overall mortality rate was 4. 0 per100 person- year. Cox regression analysis showed that the main risk factors of mortality were manifestations of AIDS related diseases or symptoms（ HR = 2. 9,95% CI： 1. 4- 5. 7） ahead of the treatment and less than 200 cells per μL of CD4 count（ HR = 2. 3,95% CI： 1. 1- 4. 6） at the initiation of HARRT.Conclusion AIDS mortality could be significantly reduced by HAART among injecting drug users and those infected heterosexually,earlier initiation of HAART is the key to reducing AIDS mortality.

关 键 词：艾滋病 抗病毒治疗 病死率 

分 类 号：R591.1[医药卫生—内科学]