两种COX模型分析中医药对艾滋病患者死亡影响因素的比较  

Comparison of Influencing Factors of Chinese Medicine on the Death of AIDS Patients by Two Cox Models

作　　者：金艳涛[1] 杨春玲 李鹏宇[1] 袁君[1] 马秀霞[1,2] 许前磊 郭会军[1,2] JIN Yan-tao;YANG Chun-ling;LI Peng-yu;YUAN Jun;MAXiu-xia;XU Qian-lei;GUO Hui-jun(Clinical Research Center of AIDS,First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000;First Clinical Medical College of Henan University of Traditional Chinese Medicine,Zhengzhou 450046)

机构地区：[1]河南中医药大学第一附属医院艾滋病临床研究中心,郑州450000 [2]河南中医药大学第一临床医学院,郑州450046

出　　处：《中国中西医结合杂志》2021年第11期1302-1306,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81803953,No.81873187);中国博士后基金项目(No.2017M612406,No.2018T110729);河南省科技攻关项目(No.182102310264)。

摘　　要：目的采用COX比例风险回归模型和边缘结构COX模型分析中医药治疗对艾滋病患者死亡的影响因素,并比较两种模型结果差异及其优劣。方法使用艾滋病患者常规治疗数据库,设计回顾性队列研究,以是否参与中医项目为分组,死亡为结局指标,采用COX比例风险回归模型和边缘结构COX模型分析中医药治疗对艾滋病患者死亡的影响因素,比较两种模型的结果并使用赤池信息量准则(AIC)比较模型的优劣。结果本研究共纳入3134例艾滋病患者,其中中医治疗组1402例,共随访9613人年,死亡272例,死亡密度为2.83/100人年;非中医治疗组1732例,共随访11997.5人年,死亡422例,死亡密度为3.52/100人年。两个模型的结果都显示中医治疗、女性、低年龄、受教育时间长和CD4+T细胞计数多是艾滋病患者死亡的保护因素。边缘结构COX模型的AIC值小于COX比例风险回归模型。结论中医药治疗有助于降低艾滋病患者的病死率,边缘COX模型可更精确地分析中医药治疗对艾滋病患者死亡的影响因素。Objective To analyze the influencing factors of Chinese Medicine(CM)on the deaths of acquired immune deficiency syndrome(AIDS)patients by using the COX proportional hazards model(PHM)and the marginal structure COX model(MSM),and compare the difference between the two models and their merits and demerits.Methods A retrospective cohort study was designed based on the conventional treatment database of AIDS patients.The participants in CM projects or not was the reason for grouping and death was taken as the outcome index.PHM and MSM were used to analyze the factors influencing the mortality of AIDS patients.akaike information criterion(AIC)was used to compared the merits of the two models.Results A total of 3134 AIDS patients were included in this study.Among them,1402 cases in the CM treatment group were followed up for 9613 person-years,272 cases died,and the death density was 2.83/100 person-years.In the non-CM treatment group,1732 cases were followed up for 11997.5 person-years,422 cases died,and the death density was 3.52/100 person-years.The results of both models showed that CM therapy,female,younger age,longer education and CD4+T cell count were more protective factors for death in AIDS patients.The AIC of MSM is lower than it of PHM.Conclusions CM treatment could reduce the mortality rate of AIDS patients.The MSM can more accurately analyze the factors influencing the death of AIDS patients treated by Chinese medicine.

关 键 词：艾滋病 中医 死亡 COX比例风险回归模型 边缘结构COX模型 

分 类 号：R259[医药卫生—中西医结合]