湖北省接受艾滋病抗病毒治疗的老年患者生存情况分析  

Survival status of elderly HIV/AIDS patients receiving highly active antiretroviral therapy in Hubei Province

作　　者：郑武[1] 笪琴[1] 汤恒[1] 彭国平[1] 

机构地区：[1]湖北省疾病预防控制中心,湖北武汉430079

出　　处：《实用预防医学》2018年第2期176-180,共5页Practical Preventive Medicine

基　　金：湖北省科技厅公益性科技研究项目(2012DCA14001)

摘　　要：目的分析湖北省接受艾滋病抗病毒治疗的老年患者基本情况及生存情况。方法回顾性分析年龄≥50岁的艾滋病患者主要流行病学特征和生存情况,并以年龄<50岁艾滋病患者为对照,进行相关分析,寿命表法计算累积生存率,Kaplan-Meier法绘制年龄≥50岁和<50岁两组艾滋病患者的生存曲线,Cox比例风险模型分析影响死亡的主要危险因素。结果≥50岁的艾滋病患者有2 643例,开始治疗的平均年龄为(58.49±7.1)岁,年龄<50岁的艾滋病患者有7 725例,开始治疗的平均年龄为(34.43±8.68)岁。两组艾滋病患者主要以男性、已婚或同居、异性性传播、初中及以下文化、基线CD4值在0~200个/μl之间、WHO临床分期为Ⅰ期、初始治疗方案为齐多夫定/司他夫定+拉米夫定+依非韦伦/奈韦拉平为主;寿命表法显示年龄≥50岁组老年艾滋病患者累积生存率从第1年的82.06%下降到第10年的53.63%,年龄<50岁组艾滋病患者累积生存率从第1年的97.48%下降到第10年的94.2%。Log-Rank检验显示年龄≥50岁组的死亡风险高于<50岁组(χ~2=209.74,P<0.001)。多因素Cox比例风险模型分析显示,文化程度、WHO临床分期、基线CD4数、初始治疗方案是年龄≥50岁组艾滋病患者死亡的危险因素(P<0.05);文化程度、婚姻状况、感染途径、WHO临床分期、基线CD4数、初始治疗方案是年龄<50岁组艾滋病患者死亡的危险因素(P<0.05)。结论湖北省接受艾滋病抗病毒治疗的老年艾滋病患者生存率低,应结合本省特点,根据老年人群的特征和死亡危险因素采取针对措施,降低老年艾滋病患者的死亡风险,提高生存率。Objective To analyze the basic situation and survival of elderly HIV/AIDS patients with highly active antiretroviral therapy in Hubei Province. Methods The main epidemiological characteristics and survival status of elderly HIV/AIDS pa- tients aged 〉I 50 years were retrospectively analyzed, and HIV/AIDS patients aged 〈 50 years served as the controls. A correlation analysis was conducted. The cumulative survival rate was calculated using the life table method. Kaplan-Meier cure described the survival curves of HIV/AIDS patients in the age groups of≥ 50 and 〈50 years, and Cox proportional hazard model was applied to determining the main risk factors influencing mortality. Results There were 2,643 HIV/AIDS patients aged≥ 50 years, and the average age of starting treatment was （58.49±7.1） years old. There were 7,725 HIV/AIDS patients aged 〈 50 years, and the average age of starting treatment was （34.43±8.68） years old. Most of HIV/AIDS patients in the two groups were males, the mar- fled or cohabitants, had acquired HIV heterosexually, had a educational background of junior middle school or below, had baseline CD4 cell counts of 0-200 cells/l^l, were classified in WHO clinical stage I, and received an initial therapy with zidovudine/ stavudine, lamivudine and efavirenz/nevirapine. The life table method showed that the cumulative survival rate of HIV/AIDS pa- tients in the age group of i〉 50 years decreased from 82.06% in the first year to 53.63% in the tenth year, and the cumulative sur- vival rate of HIV/AIDS patients in the age group of 〈 50 years decreased from 97.48% in the first year to 94.2% in the tenth year. Log-Rank test revealed that the death risk of the age group of 〉I 50 years was higher than that of the age group of 〈 50 years （χ2 = 209.74, P〈0.001}. Cox multivariate analysis showed that the educational background, WHO clinical stage, baseline CD4 cellcounts and initial therapy were the risk factors for the death of HIV/AIDS patients in the age group of ~ 50 years （

关 键 词：艾滋病 老年患者 生存分析 

分 类 号：R512.91[医药卫生—内科学]