1997—2016年舟山市艾滋病患者生存时间及影响因素分析  

Survival Time and Its Influencing Factors among AIDS Patients in Zhoushan,1997-2016

作　　者：刘登来 甘松辉 吴文杰[2] 周小军[1] LIU Deng-lai;GAN Song-hui;WU Wen-jie;ZHOU Xiao-jun(Department of Social Medicine and Health Management,School of Public Health,Nanchang University,Nanchang 330006,China;AIDS Department of Prevention andTheration,Zhoushan Disease Prevention and Control Center,Zhoushan 316000,China）ABSTRACT：)

机构地区：[1]南昌大学公共卫生学院社会医学与卫生事业管理教研室,南昌330006 [2]舟山市疾病预防控制中心艾滋病防治科,浙江舟山316000

出　　处：《南昌大学学报（医学版）》2018年第3期56-61,共6页Journal of Nanchang University：Medical Sciences

摘　　要：目的了解舟山市艾滋病患者生存时间及影响因素,为舟山市能够更有效地开展艾滋病防治提供科学依据。方法采用回顾性队列研究方法,收集舟山市报告并确诊的384例艾滋病患者的发病、死亡等信息及影响因素,用寿命表分析累积生存率,用Cox回归模型进行AIDS患者生存时间的多因素分析。结果 384例研究对象,男性占75%,男女比例31,平均年龄(42.3±15.4)岁,本市户籍占76.1%,已婚有配偶占56.3%,经性传播感染占95.6%。研究对象的平均观察时间为(42.4±42.0)个月,平均生存时间为187.97个月(95%CI 175.11~200.82),中位生存时间为216.00个月,参加AIDS抗病毒治疗(HAART)的患者平均生存时间为210.66个月(95%CI196.57~224.74),未参加HAART患者的平均生存时间111.72个月(95%CI 94.70~128.73)。研究对象总死亡率为4.24/1000人月,患者的相关死亡率为2.64/1000人月,1、3、5、10年生存率分别为92.35%、87.92%、86.13%、83.68%。多因素COX回归模型表明,CD4+细胞计数越小越容易死亡(HR=18.252,95%CI 5.492~60.658);参加HAART能有效降低AIDS患者的死亡风险(HR=0.120,95%CI 0.049~0.294)。结论不同地区、职业的AIDS患者生存时间不同,HAART可以有效延长AIDS患者的生存时间,舟山市应继续扩大HAART的覆盖面,并对AIDS患者的CD4+细胞计数进行定期检测,提高AIDS患者的生存率。ObjectiveTo understand the survival time and its influencing factors among AIDS patients in Zhoushan,and to provide a scientific basis for the effective prevention and control of AIDS. Methods A retrospective cohort study was conducted to analyze the information about onset and death and the related factors among 384 cases of confirmed AIDS in Zhoushan.Life table was applied to calculate the cumulative survival rate,and Cox proportional hazards regression model was used for multivariate analysis of survival time. Results Among the 384 patients,75% were male （male-to-female ratio,3 ： 1）.The average age was （42.3±15.4） years.In addition, 76.1% of the patients had local household registration record,56.3% were married or had a cohabiting partner,and 95.6% were infected by sexual transmission.The average observation time was （42.4±42.0） months,the average survival time was 187.97 months （95% CI 175.11-200.82）,and the median survival time was 216.00 months.The average survival time was 210.66 months （95% CI 196.57-224.74） in patients receiving highly active anti-retroviral therapy （HAART）,and 111.72 months （95% CI 94.70-128.73） in patients treated without HAART.The total mortality and AIDS-related mortality were 4.24/1000 and 2.64/1000 person-months,respectively.The 1-,3-,5- and 10-year survival rates were 92.35%,87.92%,86.13% and 83.68%,respectively.Multivariate Cox regression analysis showed that a lower CD4 ＋T lymphocyte count was associated with a higher mortality （ HR =18.252,95% CI 5.492-60.658）.The HAART could reduce the risk of death in AIDS patients （ HR =0.120,95% CI 0.049-0.294）. Conclusion The survival time of AIDS patients are varied by different regions and occupations.HAART is an effective approach to prolong the survival of AIDS patients.Therefore,HAART should be used more widely and CD4 ＋T lymphocyte count should be tested regularly to improve the survival rate of AIDS patients in Zhoushan.

关 键 词：艾滋病患者 生存时间 抗病毒治疗 CD4^+细胞计数 

分 类 号：R195.4[医药卫生—卫生统计学]