2013—2018年广州市某医院HIV感染住院患者全因病死率及死亡原因分析  

Analysis on the all-cause mortality and causes of death among HIV-infected inpatients in a hosptial in Guangzhou, 2013-2018

作　　者：陈志敏 何浩岚 刘波[1] 赵涵[1] 何耀祖 蔡卫平[1] 李凌华[1] Chen Zhimin;He Haolan;Liu Bo;Zhao Han;He Yaozu;Cai Weiping;Li Linghua(Department of Infectious Diseases,Guangzhou Eighth People's Hospital,Guangzhou Medical University,Guangzhou 510060,China)

机构地区：[1]广州医科大学附属市八医院感染病中心,510060

出　　处：《国际病毒学杂志》2021年第6期453-458,共6页International Journal of Virology

基　　金：十三五国家重大科技专项(2017ZX10202101-003-001)。

摘　　要：目的了解2013—2018年广州市某医院HIV/AIDS住院患者全因病死率的变化趋势、死亡原因构成及其影响因素。方法对广州医科大学附属市八医院2013—2018年艾滋病死亡病例499例进行回顾性分析,并对死亡病例按定义分为艾滋病相关死亡及非艾滋病相关死亡,分析患者全因病死率趋势、死亡原因构成及死亡相关危险因素。结果2013—2018年广州医科大学附属市八医院住院HIV/AIDS患者,6年总病死率为4.25%,呈逐年下降趋势(x^(2)=52.082,P<0.01)。死亡原因以艾滋病相关疾病为主,共381例,其中机会性感染343例,占68.73%,以马尔尼菲篮状菌、分枝杆菌(包括结核分枝杆菌及非结核分枝杆菌)及隐球菌3种病原感染为主。死于非AIDS相关的疾病死因共118例以非艾滋病相关恶性肿瘤、肝脏疾病为主。死亡前最近一次的CD4^(+)T淋巴细胞计数:<200 cells/µL相对于≥200 cells/µL者,病死于艾滋病相关疾病风险显著增高(OR=0.175,95%CI:0.088~0.350);未实施ART相对于已实施ART者,死于艾滋病相关疾病风险显著增高(OR=2.641,95%CI:1.513~4.609);血乳酸>2.0 mmol/L,病死于艾滋病相关疾病风险显著增高(OR=2.341,95%CI:1.366~4.014)。结论2013—2018年广州地区HIV/AIDS患者全因病死率逐年下降,死亡的主要原因仍为AIDS相关性机会性感染,ART能减少AIDS相关疾病的死亡。Objective To investigate the trend of all-cause mortality,constitution of causes of death as well as the influencing factors among HIV/AIDS inpatients in Guangzhou city from 2013 to 2018.Methods Retrospective analysis was conducted on the 499 death cases of AIDS in Guangzhou Eighth People’s Hospital,Guangzhou Medical University from 2013 to 2018.The causes of death were divided into AIDS-related and non-AIDS-related deaths according to definition,and the trend of all-cause mortality,composition of causes of death and risk factors related to death were analyzed.Results From January 2013 to December 2018,the overall mortality of HIV/ADIDS inpatients in Guanngzhou Eighth People’s Hospital,Guangzhou Medical University for the 6 years was 4.25%and the annual mortality showed a trend of decreasing(x^(2)=52.082,P<0.01).The main causes of death were AIDS-related diseases,accounting for 381 cases,including 343 cases(68.73%)of opportunistic infections.The infections were mainly caused by Talarmoyces marneffei,mycobacteria(including Mycobacterium tuberculosis and non-tuberculosis mycobacteria)and Cryptococcus.A total of 118 patients died of non-AIDS-related diseases,mainly non-AIDS-related malignancy and liver diseases.The risk of death due to AIDS-related diseases among patients with the last CD4^(+)T-lymphocyte count of<200 cells/µL before death was significantly higher than the patients with≥200cells/µL(OR:0.175,95%CI:0.088-0.350).The risk of death due to AIDS-related diseases among patients without receiving ART therapy was significantly higher for the patients receiving the treatment(OR:2.641,95%CI:1.513-4.609).Blood lactic acid>2.0mmol/L increased significantly the risk of death due to AIDS-related diseases(OR:2.341,95%CI:1.366-4.014).Conclusions From 2013 to 2018,the all-cause mortality of HIV/AIDS patients decreased annually.The main cause of death was still AIDS-related opportunistic infection.The ART therapy may reduce the death of AIDS-related diseases.

关 键 词：HIV AIDS 全因病死率 死亡原因 

分 类 号：R512.91[医药卫生—内科学] R181.3[医药卫生—临床医学]