河北省HIV/AIDS病例生存时间及影响因素分析  

Analysis of survival time and influencing factors of HIV/AIDS patients,Hebei Province

作　　者：张亚丽[1] 王敬丘 王伟[1] 吴小雪 马琳[1] 成效莹 ZHANG Ya-li;WANG Jing-qiu;WANG Wei;WU Xiao-xue;MA Lin;CHENG Xiao-ying(Hebei Provincial Center for Disease Control and Prevention,Shijiazhuang,Hebei 050021,China)

机构地区：[1]河北省疾病预防控制中心,河北石家庄050021

出　　处：《现代预防医学》2025年第6期1138-1143,共6页Modern Preventive Medicine

基　　金：河北省重点研发计划自筹项目(172777185)。

摘　　要：目的分析河北省感染艾滋病病毒感染者和艾滋病患者(HIV/AIDS)的生存时间,探索其影响因素,为提高患者生存质量提供依据。方法采用回顾性队列研究方法,收集河北省1989—2022年发现的HIV/AIDS病例的各类随访信息,用寿命表法描述其生存情况,用log-rank检验及Cox回归分析生存时间的影响因素。结果22563例HIV/AIDS病例,男性占88.7%,同性传播占62.1%,发现时平均年龄为38.1±13.9岁。1年生存率91.46%,3年生存率88.03%,5年生存率85.56%,10年生存率达79.34%。多因素分析结果显示,女性死亡风险小于男性(HR=0.824,95%CI:0.713~0.953)。接受抗病毒治疗者死亡风险低于未治疗者(HR=0.079,95%CI:0.069~0.091)。基线CD4细胞计数在200~349个/μl(HR=0.451,95%CI:0.222~0.914)、计数在350~499个/μl(HR=0.354,95%CI:0.175~0.719)、计数在500个/μl以上者(HR=0.342,95%CI:0.168~0.693)死亡风险较低。50岁以上者死亡风险较高(HR=2.585,95%CI:2.143~3.117)。病例样本来源中,来源于检测咨询的病例死亡风险低于来源于医疗机构的病例(HR=0.444,95%CI:0.387~0.510),来源于羁押人员的病例死亡风险低于来源于医疗机构的病例(HR=0.417,95%CI:0.297~0.584)。结论性别、文化程度、基线CD4细胞计数、样本来源、发现时年龄、是否开展抗病毒治疗是生存时间的影响因素。早发现,早治疗,加强重点人群的宣传教育,关注50岁以上中老年病例,强化医务人员主动开展艾滋病检测咨询服务,对于延长HIV/AIDS病例的生存时间具有积极的作用。Objective To analyze the survival time of HIV/AIDS patients in Hebei province,and to explore the influencing factors,so as to provide basis for improving the quality of life of patients.Methods Retrospective cohort study was used to collect information of HIV/AIDS in Hebei province from 1989 to 2022.Life table was used to describe the survival status.Log-rank test and Cox regression were used to analysis the influencing factors of survival time.Results There were 22563 cases of HIV/AIDS,with males accounting for 88.7%and homosexual transmission accounting for 62.1%.The average age at the time of discovery was 38.1±13.9.The 1-year,3-year,5-year and 10-year cumulative survival rates of HIV/AIDS patients were 91.46%,88.03%,85.56%and 79.34%.The risk of death in female was lower than that in male(HR=0.824,95%CI:0.713-0.953).The risk of death in patients receiving antiviral treatment was lower than in those who have not received treatment(HR=0.079,95%CI:0.069-0.091).Baseline CD4 cell counts ranging from 200 to 349 cells/μl(HR=0.451,95%CI:0.222-0.914),350 to 499 cells/μl(HR=0.354,95%CI:0.175-0.719),and above 500 cells/μl(HR=0.342,95%CI:0.168-0.693)have a lower risk of death.People over 50 years old have a higher risk of death(HR=2.585,95%CI:2.143-3.117).Among the sources of case samples,the case death risk of those from HIV testing and counseling was lower than the cases from medical institutions(HR=0.444,95%CI:0.387-0.510).And the case death risk of those from detainees was lower than the cases from medical institutions(HR=0.417,95%CI:0.297-0.584).Conclusion Gender,educational level,baseline CD4 cell count,sample source,age at discovery,and antiviral treatment were influencing factors on survival time.Early detection,early treatment,strengthening the publicity and education of key groups,paying attention to the elderly cases over 50 years old,and strengthening medical personnel to actively carry out AIDS testing and consulting services have a positive effect on prolonging the survival time of HIV/AIDS cases.

关 键 词：艾滋病 生存时间 影响因素 COX回归 

分 类 号：R521.91[医药卫生—内科学]