2005-2015年凉山彝族自治州艾滋病抗病毒治疗患者生存时间及相关因素分析  

Survival time and related factors of antiretroviral therapy among HIV/AIDS patients in Liangshan Prefecture,during 2005-2015

作　　者：姜雪[1] 赵燕[2] 吉克春农 许佳莉 余刚[3] 俞海亮[2] 王菊[3] 赵德才[2] 廖强[3] 甘秀敏[2] 刘中夫[2] Jiang Xue;Zhao Yan;Jike Chunnong;Xu Jiali;Yu Gang;Yu Hailiang;Wang Ju;Zhao Decai;Liao Qiang;Gan Xiumin;Liu Zhongfu(The Hospital of Shunyi District Beijing Infection Management Department,Beijing 101300,China;National Center for AIDS/STD Control and Prevention,China CDC,Beijing 102206,China;Center for Disease Control and Prevention ofLiangshan Prefecture,Xichang 615000,China)

机构地区：[1]北京市顺义区医院医院感染管理科,北京101300 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [3]四川省凉山彝族自治州疾病预防控制中心,西昌615000

出　　处：《中华预防医学杂志》2020年第11期1237-1242,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金(71774150,71573239)。

摘　　要：目的分析四川省凉山州艾滋病抗病毒治疗患者接受抗病毒治疗后生存时间及影响因素。方法采用回顾性研究方法收集相关信息,选取国家艾滋病综合防治数据信息系统中的艾滋病患者为研究对象。纳入标准为:2005—2015年在凉山州接受抗病毒治疗且年龄≥15周岁的HIV感染者/艾滋病患者,共14219例。采用Kaplan-Meier法绘制生存曲线,进行抗病毒治疗患者生存时间的单因素分析,采用Cox比例风险模型进行多因素分析。结果研究对象的年龄为(36.10±9.41)岁,其中男性10021例,占70.5%,感染途径以静脉吸毒为主(61.0%,8678例);至随访观察终止时间,依然在治者10001例(70.3%),死亡1425例(10.0%);Cox回归分析结果显示,女性[HR(95%CI值)=0.67(0.55~0.81)]、性感染途径[HR(95%CI值)=0.67(0.56~0.79)],CD4^+T淋巴细胞计数在200~350[HR(95%CI值)=0.41(0.35~0.47)]及≥350者[HR(95%CI值)=0.28(0.24~0.34)],是死亡的保护性因素,而开始治疗时患者临床分期Ⅱ期[HR(95%CI值)=0.70(0.58~0.84)],以及体重指数异常[HR(95%CI值)=1.75(1.50~2.03)]是死亡的危险因素(以上P值均<0.05)。结论早期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,应进一步加强HIV感染者/AIDS患者抗病毒治疗相关知识宣传教育,提高患者治疗依从性,还可通过营养支持的方式,增强患者体质,从而延长其生存时间,提高生存质量。Objective To analyze the survival time and to explore the releated factors of antiretroviral therapy among HIV/AIDS patients in LiangShan Prefecture,Sichuan Province for reduction of AIDS death rate.Methods The retrospective research method was used to collect relevant information from the Management Database of Antiviral Treatment from the National AIDS Comprehensive Prevention Information System.The Kaplan-Meier method was used to describe the survival distribution and to analyze the survival time by single factor and the model of Cox proportional riskanalysis was performed to analyze the survival time of HARRT by multi-factors analysis.Results Total 14219 adults and young persons aged≥15 HIV/AIDS patients received antiviral treatment from 2005 to 2015.The average age of all cases was(36.10±9.41)years old and 10021 were males(70.5%).The main route of infection was intravenous drug use(61.0%,8678 cases).At the end of the observation,10001 cases(70.3%)were still treated,and 1425 cases(10.0%)died;Cox Regression analysis showed that female(0.67(0.55-0.81)),route of sexual infection(0.67(0.56-0.79)),baseline CD4^+T lymphocyte count 200-350(0.41(0.35-0.47))and≥350(0.28(0.24-0.34)),was a protective factor in death.At the beginning of treatment,the patient is clinically staging stageⅡ(0.70(0.58-0.84))and abnormal BMI(1.75(1.50-2.03)),is a risk factor for death(P<0.05).Conclusion Early antiviral treatment is of great significance in improving the anti-viral treatment effect of AIDS.Compliance education should be further strengthened so as to enhance their knowledge.And it is feasible to enhance the effect of treatment through nutritional support for prolonging patients survival time and improving the quality of life.

关 键 词：HIV 获得性免疫缺陷综合征 性传播疾病 病毒性 生存时间 

分 类 号：R512.91[医药卫生—内科学]