重庆市2004-2013年艾滋病抗病毒治疗患者生存时间及影响因素分析  

Survival and influencing factors analysis on AIDS antiretroviral therapy in Chongqing during 2004- 2013

作　　者：何海[1] 李巧巧[1] 周超[2] 曾璨[1] 崔鑫宇 吴国辉[2] 栾荣生[1] 

机构地区：[1]四川大学华西公共卫生学院流行病与卫生统计学系,四川成都610041 [2]重庆市疾病预防控制中心性病艾滋病防治所,重庆400042

出　　处：《中华疾病控制杂志》2016年第1期21-25,共5页Chinese Journal of Disease Control & Prevention

基　　金：中国-默沙东艾滋病合作项目Ⅱ期(A42001)

摘　　要：目的了解重庆市接受艾滋病高效抗病毒治疗的患者的生存状况及影响因素。方法利用国家艾滋病抗病毒治疗信息系统，收集患者的生存、死亡信息，采用SPSS17．0进行数据分析。结果共收集N8991例于重庆市接受艾滋病抗病毒治疗的患者的流行病学信息，因艾滋病相关疾病死亡592例，艾滋病患者总病死率5．40／1000人月，患者1～5年累计生存率分别为0．92、0．90、0．89、0．87、0．84。多因素Cox回归提示相对于入组年龄〈30岁组，30-岁组、40-岁组、≥50岁组HR（95％CI）分别为1．424（1．025-1．978）、1．881（1．362～2．597）、2．853（2．072-3．927）；相对于基线CD4＋T淋巴细胞计数≥200个／mm^3组，CD4＋T淋巴细胞计数〈100个／mm^3组与100～个／mm^3组HR（95％CI）分别为4．847（3．792～6．196）、1．962（1．486～2．590）；感染途径为静脉吸毒（HR=1．964，95％CI：1．544～2．498）、入组时艾滋病相关疾病或症状（HR=2．658，95％CI：2．221～3．181）也是艾滋病相关疾病死亡的危险因素。结论重庆市艾滋病抗病毒治疗有效地减少了艾滋病相关疾病死亡，延长了患者生存时间；降低治疗门槛，及时纳入患者进行抗病毒治疗对提高艾滋病抗病毒治疗效果有重要意义。Objective To study the effect and the influencing factors of the highly active antiretroviral therapy （HAART） in Chongqing. Methods Data on the survival and death of AIDS patients were collected from the National HAART reporting system between 2004 and 2013, and analyzed using SPSS 17.0 software. Results 8 991 cases were en- rolled in this study, 592 died of AIDS. Total AIDS mortality was 5.40/1 000 person-months. The cumulative survival rate of antiretroviral therapy after 1-5 years were 0. 92,0. 90,0. 89,0. 87,0. 84 respectively. Data from Cox proportional hazard regression model analysis indicated that after adjustment for other influencing factors, the risk of death increased with the growing age and lower baseline CIM ~T cells counts. The HR（95% CI） of 30-39 years,40-49 yrears and ≥50 years group were 1. 424 （ 1. 025-1. 978 ）, 1.881 （ 1. 362-2. 597 ）, 2. 853 （ 2. 072-3. 927 ） relative to 〈 30 years group, respectively. The HR（95% CI） of 100-199/mm3 and 〈 100/mm3 baseline CD4＋T cells counts group were 1. 962（ 1. 486-2. 590）,4. 847 （3. 792-6. 196） relative to≥200/mm3 group. The intravenous drug users（HR = 1. 964,95% CI：1. 544-2. 498） , opportun- istic infection or manifestation（HR = 2. 658,95% CI：2. 221-3. 181 ） were also the risk factors of death. Conclusions The HARRT had significantly reduced the mortality rate. To improve the effect of HARRT in Chongqing, more effective meas- ures should to be taken to make the AIDS patients enrolled HAART earlier.

关 键 词：获得性免疫缺陷综合征 抗病毒药 流行病学研究 

分 类 号：R512.91[医药卫生—内科学] R181[医药卫生—临床医学]