摘要
目的了解2011-2019年云南省结核病并发艾滋病患者在抗结核治疗期间死亡的影响因素,为结核病并发艾滋病患者的防治提供参考依据。方法利用《结核病信息管理系统》,收集2011年1月至2019年12月云南省接受抗结核治疗的3329例结核病并发艾滋病患者的治疗信息,描述在抗结核治疗期间死亡的246例(7.39%)患者的人口学特征、临床特征、抗病毒治疗等情况。利用Kaplan-Meier法、Log-rank检验和Cox比例风险回归模型对患者死亡的影响因素进行分析。结果246例患者中,抗结核治疗强化期死亡98例(39.84%)。死亡患者中男性占81.71%(201/246),246例死亡患者年龄中位数(四分位数)[M(Q1,Q3)]为40(33,48)岁。Cox回归模型显示,≥60岁(aHR=2.00,95%CI=1.27~3.15)、CD4^(+)T淋巴细胞水平50~<400个/μl(aHR=3.23,95%CI=1.63~6.42)、CD4^(+)T淋巴细胞水平<50个/μl(aHR=8.96,95%CI=4.37~18.38)、仅抗结核治疗(aHR=1.74,95%CI=1.13~2.67)、在结核病定点医院治疗(aHR=1.58,95%CI=1.19~2.10)的患者死亡风险更高。结论结核病并发艾滋病患者在抗结核治疗期间死亡风险较高;应重点关注≥60岁、抗结核治疗强化期的患者,并加强对定点医院医生的结核病防治培训,提升诊断治疗能力,以降低结核病并发艾滋病患者病亡率。
Objective To investigate the influencing factors for deaths of tuberculosis(TB)patients complicated with acquired immune deficiency syndrome(AIDS)during anti-tuberculosis treatment in Yunnan province from 2011 to 2019,so as to provide a reference for the prevention and treatment of TB patients complicated with AIDS.Methods Treatment information about 3329 TB patients complicated with AIDS receiving antituberculosis treatment in Yunnan province from January 2011 to December 2019 was collected via the"Tuberculosis Management Information System".The demographic characteristics,clinical characteristics,and antiviral treatment of 246 patients(7.39%,246/3329)who died during anti-tuberculosis treatment were described.Kaplan-Meier method,Log-rank test and Cox proportional hazard regression model were used to analyze the influencing factors of death.Results Among the 246 patients,98(39.84%,98/246)died during intensive phase of anti-tuberculosis treatment.The majority of death cases were males(81.71%,201/246);the median age(M(Q1,Q3))of them was40(33,48)years.Cox regression model showed that patients over 60 years old(aHR=2.00,95%CI=1.27-3.15),with a CD4^(+)T lymphocyte level of 50-<400 cells/μl(aHR=3.23,95%CI=1.63-6.42),CD4^(+)T lymphocyte level<50 cells/μl(aHR=8.96,95%CI=4.37-18.38),only taking anti-tuberculosis treatment(aHR=1.74,95%CI=1.13-2.67),patients treated in designated TB hospitals(aHR=1.58,95%CI=1.19-2.10)had a higher risk of death.Conclusion TB patients complicated with AIDS had a relatively high risk of death during anti-tuberculosis treatment.We should especially focus on patients in the intensive phase of antituberculosis treatment,and those over 60 years old.In addition,tuberculosis prevention and treatment training should be strengthened for doctors in TB designated hospitals to improve diagnostic and therapeutic capabilities,so as to reduce the fatality rate of those patients.
作者
叶锦欣
许琳
陈金瓯
邱玉冰
律彤
YE Jin-xin;XU Lin;CHEN Jin-ou;QIU Yu-bing;LYU Tong(School of Public Health,Kunming Medical University,Kunming 650000,China;不详)
出处
《中国防痨杂志》
CAS
CSCD
2021年第2期126-131,共6页
Chinese Journal of Antituberculosis
基金
云南省结核病防治所项目(2016NS143)。
关键词
结核
艾滋病
死亡
因素分析
云南省
Tuberculosis
Acquired immune deficiency syndrome
Death
Factor analysis
Yunnan province
