摘要
目的了解浙江省桐乡市获得性免疫缺陷综合征(AIDS)患者接受高效抗反转录病毒疗法(HAART)后的生存状态及影响因素。方法回顾性调查桐乡市2004年1月—2019年6月所有初次接受HAART治疗的人类免疫缺陷病毒(HIV)感染者和AIDS患者,用Kaplan-Meier法估计生存率,Cox比例风险模型分析与生存状态有关的影响因素,并采用Log Rank、Breslow和Tarone-Ware三种检验方法分析组别间生存时间是否存在组间差别。结果共纳入363例研究对象,截至2019年12月31日仍在治341例(93.94%)。研究对象最近1次CD4淋巴细胞检测结果平均值(431.86±224.47)个/μl,基线CD4淋巴细胞检测结果平均值(253.66±148.99)个/μl,治疗后总病死率为2.34/100人年,确诊年龄、基线CD4淋巴细胞计数、最近一次CD4淋巴细胞计数、WHO临床分期和基线丙氨酸氨基转移酶(ALT),差异均有统计学意义(P均<0.05)。Cox比例风险回归模型分析显示,基线丙氨基酸基转移酶异常组的死亡风险是正常组的5.082倍,最近一次CD4淋巴细胞≤50个/μl组别的死亡风险是>200个/μl组的10.31倍;年龄≥60岁组别的死亡风险是<30的15.13倍。对不同(确诊年龄、基线CD4淋巴细胞计数、最近1次CD4淋巴细胞计数、基线丙氨酸氨基转移酶)组别间生存时间差异有统计学意义(P<0.05)。结论桐乡市艾滋病抗病毒治疗效果较好,及时规范、并早期启动HAART能够规范随访监测,提高患者生存率。
Objective To discuss the survival status of adult HIV/AIDS patients receiving highly active antiretroviral therapy(HAART)in Tongxiang city of Zhejiang province,and to discuss its influencing factors.Methods A retrospective cohort survey was conducted among 363 HIV/AIDS patients receiving initial HAART in Tongxiang city from January 2004 to June 2019.Kaplan-Meier method was used to estimate the survival rate,and Cox regression model was applied to analyze the risk factors associated with the survival of subjects.Log Rank,Breslow and Tarone-Ware test were used to identify the ordinal tendency of different groups.Results By December 31,2019,there were 341 cases(93.94%)still being treated.The average baseline CD4 cell count was(253.66±148.99)cells/μl,while it went up to(431.86±224.47)cells/μl in the most recent test.The overall post treatment mortality rate was 2.34/100 person-year.The differences in age at diagnosis,baseline and most recent CD4 cell counts,WHO clinical stage and baseline ALT were statistically significant(P<0.05).Cox proportional hazard analysis indicated that the risk of death in subjects with abnormal baseline ALT was 5.13 times higher than that in those with normal ALT,10.31 times higher in subjects with CD4 cell count of≤50 cells/ul than that in those with CD4 cell count of>200 cells/ul,and was 15.13 times higher in subjects aged 60 years and above than that in those younger than 30 years old.There were statistically significant differences in survival time among different groups(age at diagnosis,baseline and latest CD4 cell count,baseline ALT)(P<0.05).Conclusions The therapeutic effect of HAART for HIV/AIDS in Tongxiang is satisfactory.Early standardized treatment and follow-up monitoring can help to improve the survival of HIV/AIDS patients.
作者
辅海平
FU Hai-ping(Tongxiang Center for Disease Control and Prevention,Tongxiang,Zhejiang 314500,China)
出处
《中国预防医学杂志》
CAS
CSCD
2020年第11期1161-1165,共5页
Chinese Preventive Medicine
基金
十三五国家科技重大专项基金资助项目(2017ZX10105001)。
关键词
人类免疫缺陷病毒
艾滋病
HAART
生存分析
Human immunodeficiency virus(HIV)
Acquired immune deficiency syndrome(AIDS)
Highly active antiretroviral therapy(HAART)
survival analysis
