1989至2020年北京市东城区1076例人类免疫缺陷病毒感染者/获得性免疫缺陷综合征患者生存时间及影响因素  

Survival period and influencing factors of 1076 patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome in Dongcheng District,Beijing from 1989 to 2020

作　　者：田飞[1] 高颂[1] 李铮 王颖慧 王媛媛[1] Tian Fei;Gao Song;Li Zheng;Wang Yinghui;Wang Yuanyuan(Department of STD/AIDS Prevention and Treatment,Center for Diseases Control and Prevention of Dongcheng District,Beijing,Beijing 100050,China)

机构地区：[1]北京市东城区疾病预防控制中心性病艾滋病防治科,北京100050

出　　处：《中华实验和临床感染病杂志（电子版）》2022年第2期100-107,共8页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的探讨北京市东城区人类免疫缺陷病毒感染者/获得性免疫缺陷综合征(HIV/AIDS)患者生存时间及影响因素。方法采用回顾性队列研究方法,在中国艾滋病综合防治信息系统中收集1989年1月1日~2020年12月31日北京市东城区HIV/AIDS患者共1076例的临床资料,应用寿命表法分析累积生存率;利用Kaplan-Meier法(K-M法)绘制生存曲线;利用COX比例风险模型分析影响患者生存时间的因素。结果所有研究对象中,完成随访1072例(99.63%),失访4例(0.37%);随访过程中发生AIDS相关死亡26例(2.42%);第1、2、5年累计生存率分别为98.03%、97.92%和97.47%。研究对象生存时间中位数为264.00个月。COX比例风险模型分析显示:首次检测CD4^(+)T细胞计数<350个/μl(HR=4.053、95%CI:1.412~11.628)、确诊时为AIDS患者(HR=20.651、95%CI:4.741~89.940)、未接受抗病毒治疗(HR=30.722、95%CI:12.389~76.18)均为患者生存时间缩短的危险因素。与初中及以下文化程度的HIV/AIDS患者相比,较高文化程度为延长患者生存时间的保护因素(高中或中专:HR=0.317、95%CI:0.122~0.826,大专及以上:HR=0.155、95%CI:0.055~0.439)。K-M法绘制生存曲线显示,大专及以上、高中或中专文化程度HIV/AIDS患者累计生存率显著高于初中及以下文化程度HIV/AIDS患者(χ^(2)=26.978、P<0.001)。首次检测CD4^(+)T细胞计数≥350个/μl、确诊时疾病状态为HIV感染、行抗病毒治疗的HIV/AIDS患者累计生存率高于首次检测CD4^(+)T细胞计数<350个/μl、确诊时疾病状态为AIDS、未行抗病毒治疗的HIV/AIDS患者(χ^(2)=14.329、44.559、126.836,P均<0.001)。结论北京市东城区HIV/AIDS患者中接受抗病毒治疗、首次CD4^(+)T细胞计数≥350个/μl、确诊时疾病状态为HIV感染、大专及以上文化程度者生存时间较长。故提高筛查力度,尽可能早期发现HIV感染者,尽快开展治疗,可提高其确诊后生存质量和生存时间。Objective To investigate the survival period and influencing factors of patients infected with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)in Dongcheng District,Beijing.Methods A retrospective cohort study was conducted to collect 1076 HIV/AIDS patients in Dongcheng District of Beijing from January 1st,1989 to December 31st,2020 in China Integrated AIDS Prevention and Control Information System.Cumulative survival rate was analyzed by life table method.Kaplan-meier method(K-M method)was used to plot the survival curve.COX proportional risk model was used to analyze the influencing factors of survival period.Results Among all the subjects,1072 cases(99.63%)were followed up,and 4 cases(0.37%)were lost.There were 26 AIDS-related deaths(2.42%)during the follow-up.The cumulative survival rates at the first,the second and the fifth year were 98.03%,97.92%and 97.47%,respectively.The median survival period of the subjects was 264.00 months.COX proportional risk model analysis showed that initial CD4^(+)T<350 cells/μl(HR=4.053,95%CI:1.412-11.628),AIDS patients with disease status at diagnosis(HR=20.651,95%CI:4.741-89.940),no antiviral therapy(HR=30.722,95%CI:12.389-76.18)were risk factors to reduce their survival period.Compared with HIV/AIDS patients with junior school education or below,higher education was a protective factor for prolonging survival(senior school/professional school degree:HR=0.317,95%CI:0.122-0.826;College degree or above:HR=0.155,95%CI:0.055-0.439).The survival curve by K-M method showed that the cumulative survival rate of HIV/AIDS patients with college degree or above,high school or secondary school education was higher than that of HIV/AIDS patients with junior school education(χ^(2)=26.978,P<0.001).The cumulative survival rate of HIV/AIDS patients whose initial CD4^(+)T≥350 cells/μl and whose disease status at diagnosis was HIV-infection and those who received antiviral therapy was higher than that of initial CD4^(+)T<350 cells/μl,patients with AIDS status at di

关 键 词：人类免疫缺陷病毒 获得性免疫缺陷综合征 回顾性分析 生存分析 影响因素 

分 类 号：R512.91[医药卫生—内科学]