贵阳市艾滋病患者抗病毒治疗结局及影响因素分析  

Analysis of the outcomes of and influencing factors for antiviral therapy among patients with AIDS in Guiyang City

作　　者：黄璐[1] 申莉梅[1] 陈洋[1] 安竹[1] 李畅畅[2] 

机构地区：[1]贵州省疾病预防控制中心艾滋病防治研究所,贵州贵阳550004 [2]中山大学公共卫生学院,广州广东510080

出　　处：《现代预防医学》2016年第14期2632-2634,2662,共4页Modern Preventive Medicine

基　　金：中美艾滋病防治合作项目(5U2GGH001153-02)

摘　　要：目的了解影响贵阳市艾滋病患者抗病毒治疗效果的影响因素。方法选择艾滋病综合防治信息管理系统中2014年以前首次接受抗病毒治疗的成年患者建立回顾性队列,收集患者的个人基本信息、艾滋病临床信息,并随访监测生存状况。运用频数和比率描述计数资料,运用均数和标准差描述计量资料,单因素分析采用χ~2检验,多因素分析采用Cox回归。结果 1 682例研究对象的平均年龄为(42.31±12.7)岁,男性占71.9%,已婚或同居的占57.6%,经性传播感染的占70.0%。至观察时间结束时,仍在治疗、停药、失访、死亡的构成比分别为85.0%、1.4%、5.2%、1.8%,93.5%的死亡病例死于艾滋病相关疾病。在随访期间,研究对象平均时间为(32.59±20.93)个月。多因素分析结果显示:临床II期、临床Ⅲ期、近3个月患艾滋病相关疾病、初始CD_4^+T淋巴细胞计数值介于200到350之间是引起死亡的高危因素。结论疾病预防控制部门应做好艾滋病病毒感染者及病人的随访监测工作,以尽早把握治疗最佳时机,确保治疗效果。Objective The aim of the study was to assess the influencing factors for effectiveness of antiviral therapy among AIDS patients in Guiyang City. Methods Adult AIDS patients who received an initial antiviral therapy treatment before 2014 as recorded in the AIDS Comprehensive Prevention and Treatment Information Management System were selected to establish a retrospective cohort. Personal infoimation and clinical information of the AIDS patients were collected, and the survival status of the patients was followed. Enumeration data were obtained from frequency and ratio, measurement data were obtained from mean and standard deviation, E2 test was used for univariate factor analysis, and Cox regression model was used for multivariate analysis. Results The average age of the 1682 selected subjects was 42.31±12.7. 71.9% of the cases were male, 57.6% were married or had a cohabiting partner, and 70.0% were infected by sexual transmission. At the end of the observation, the constituent ratio of patients who were still receiving treatments or had stopped their medications, lost contact, or passed away was 85.0%, 1.4%, 5.2%, and 1.8%; and 93.5% of the death cases died of AIDS related illnesses. During the follow-up, the average survival time of the patients 32.59±20.93 months. Multivariate analysis showed that clinical stage II, clinical stage III, having AIDS related illnesses in the last 3 months, and CD4＋ T cells baseline count between 200 and 350 were the high-risk factors for death among the AIDS patients. Conclusion Disease control and prevention agencies should improve follow-ups and monitoring of HIV-infected or AIDS patients, so as to allow early treatment of the patients and ensure treatment effectiveness.

关 键 词：艾滋病 高效抗反转录病毒疗法 结局 分析 

分 类 号：R181.13[医药卫生—流行病学]