成都市成华区2004-2016年接受艾滋病抗病毒治疗的患者生存情况及其影响因素分析  

Survival and influencing factors of patients receiving AIDS antiretroviral therapy in Chenghua district,Chengdu,2004-2016

作　　者：唐雪蕾 何海 王德伟 李虹璇 王嘉川[3] 蔡端 凌海洋 李苑[6] 

机构地区：[1]成都市成华区疾病预防控制中心,四川成都610000 [2]四川大学华西公共卫生学院(华西第四医院),四川成都610000 [3]核工业四一六医院,四川成都610000 [4]新鸿路社区卫生服务中心,四川成都610000 [5]双水碾社区卫生服务中心,四川成都610000 [6]成都中医药大学,四川成都610000

出　　处：《现代预防医学》2018年第1期145-148,168,共5页Modern Preventive Medicine

基　　金：中国全球基金艾滋病项目(CHN-304-G03-H);中英艾滋病策略支持项目

摘　　要：目的了解成都市成华区艾滋病患者在接受抗病毒治疗后的生存情况和影响因素。方法通过国家艾滋病综合防治管理系统,收集成华区2004-2016年的成年艾滋病患者的基础、随访、治疗及转归信息,采用SPSS17.0进行数据分析。结果共收集到1 431例成华区艾滋病抗病毒治疗患者的流行病学信息,其中死亡53例,病死率为3.7%,患者在第1~5年的累计生存率为0.97、0.96、0.96、0.95、0.93,6年以上患者累计生存率为0.92。多因素Cox比例风险显示相对于入组治疗年龄<30岁者,30~39岁、40~49岁及≥50组患者死亡相对危险度分别为0.796(95%CI:0.351~1.804),1.698(95%CI:0.784~3.680),2.513(95%CI:1.260~5.013);相对于基线CD4^+T淋巴细胞计数<100个/mm^3者,基线CD4细胞计数100~199个/mm^3与≥200个/mm^3组患者死亡相对危险度分别为0.602(95%CI:0.313~1.156),0.186(95%CI:0.094~0.365)。结论成华区以社区为核心的艾滋病抗病毒治疗成效明显,降低抗病毒治疗门槛,及早发现并开展治疗,加强对高龄患者的关注,对延迟艾滋病患者生存时间,提高抗病毒治疗成效有重要意义。Objective To study the survival situation and influencing factors of patients receiving highly active antiretroviral therapy（HAART） in Chenghua district, Chengdu. Methods Data of the baseline, follow - up, treatment and death of AIDS patients were collected from the National HAART reporting system between 2004 and 2016, and SPSS17.0. was used to analyze the data. Results The epidemiological information of 1 431 patients with AIDS was collected, of which 53 were dead, and the fatality rate was 3.7%. The cumulative survival rate of patients in year 1 - 5 were 0. 97 , 0. 96 , 0. 96 , 0. 95 and 0.93 ,and the cumulative survival rate was 0. 92 for patients over 6 years. Multivariate Cox proportional hazards indicated that the risk of death increased with the growing age and lower baseline CD4＋T ceils counts. The HR of 30 -39 years,40 - 49 years,and ≥50 years group were 0. 796 （ 95 % CI： 0.351 - 1. 804 ）, 1. 698 （ 95 % CI： 0. 784 - 3. 680 ） ,2.513 （ 95 % CI： 1. 260 - 5.013 ） relative to 〈 30 years group ,respectively. The HR of 100 - 199/mm3 and ≥200/mm3 baseline CD4 ＋ T cells counts group were 0.602（95% CI： 0.313 ＋ 1. 156） ,0. 186 （95% CI：O. 094＋ 0. 365 ） relative to 〈 100/mm3 baseline CD4 ＋ T cells counts group. Conclusion HAART work based on community achieve remarkable effect. Reducing the threshold of antiviral therapy, early detection and treatment, and strengthening the attention of the elderly patients are important for increasing the survival time of AIDS patients and improving the effectiveness of antiviral treatment.

关 键 词：艾滋病 抗病毒治疗 生存分析 成华区 

分 类 号：R181.23[医药卫生—流行病学]