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姚书杰, 周金玲, 王莉, 姚文清. 辽宁省艾滋病抗病毒治疗死亡患者生存时间及相关因素分析[J]. 中国公共卫生, 2016, 32(12): 1633-1637. DOI: 10.11847/zgggws2016-32-12-08
引用本文: 姚书杰, 周金玲, 王莉, 姚文清. 辽宁省艾滋病抗病毒治疗死亡患者生存时间及相关因素分析[J]. 中国公共卫生, 2016, 32(12): 1633-1637. DOI: 10.11847/zgggws2016-32-12-08
YAO Shu-jie, ZHOU Jin-ling, WANG Li.et al, . Survival time and its related factors among AIDS mortalities with HAART in Liao-ning province[J]. Chinese Journal of Public Health, 2016, 32(12): 1633-1637. DOI: 10.11847/zgggws2016-32-12-08
Citation: YAO Shu-jie, ZHOU Jin-ling, WANG Li.et al, . Survival time and its related factors among AIDS mortalities with HAART in Liao-ning province[J]. Chinese Journal of Public Health, 2016, 32(12): 1633-1637. DOI: 10.11847/zgggws2016-32-12-08

辽宁省艾滋病抗病毒治疗死亡患者生存时间及相关因素分析

Survival time and its related factors among AIDS mortalities with HAART in Liao-ning province

  • 摘要: 目的 探讨艾滋病(AIDS)患者生存时间及其影响因素。方法 采用回顾性队列研究方法,收集辽宁省接受高效抗反转录病毒治疗(HAART)且已死亡人免疫缺陷病毒感染者(HIV)/AIDS发病、死亡等信息并统计分析。结果 自2003年12月-2014年12月底,310例AIDS HAART死亡患者,AIDS相关死亡187例(60.32%),意外死亡和自杀等非AIDS相关死亡123例(39.68%);接受治疗前中位生存时间为3.00(95%CI=2.00~4.00)个月,接受治疗后的前6、6~12、12~18个月的累积生存率分别为(57±3)%、(44±3)%、(36±3)%。不同世界卫生组织(WHO)临床分期、基线CD4+T淋巴细胞水平组间生存时间差异明显(P<0.05)。WHO临床分期Ⅲ期或Ⅳ期患者死亡风险是Ⅰ期或Ⅱ期患者1.973倍,基线CD4+T淋巴细胞为50~199、≥200个/μL组患者死亡风险分别是<50个/μL组0.442倍和0.512倍。结论 死亡集中发生于开始治疗后的前6个月,随着时间延长,死亡速度减缓。基线CD4+T淋巴细胞水平低、WHO临床分期Ⅲ期或Ⅳ期是抗病毒治疗患者死亡危险因素。

     

    Abstract: Objective To analyze the survival time and its related factors in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients in Liaoning province.Methods A retrospective cohort study was conducted to analyze the survival time and its related factors among 310 HIV/AIDS mortalities with the history of highly active antiretroviral therapy(HAART).Kaplan-Meier method was used to describe the survival distribution and life table was applied to calculate the survival proportion.Cox proportional hazard model was performed to identify the factors associated with the survival.Results Among the 310 HIV/AIDS deaths between December 2003 and December 2014,187 (60.32%) were died of AIDS-related diseases and 123 (39.68%) were died of accident,suicide,and the diseases other than AIDS.The overall median survival time was 3.00 months (95% confidence interval 95%CI:2.00-4.00) before HAART;the cumulative survival rate was 57±3%,44±3%,and 36±3% in the first 6 months,6-12 months,and 12-18 months after the HAART.The survival time was significantly different among the mortalities with different clinical stage of World Health Organization (WHO) and different CD4+T cell count.The mortality risk of the cases with WHO clinical stage of Ⅲ or IV was 1.973 compared to the cases with the clinical stage of I or Ⅱ.The mortality risk of the cases with the baseline CD4+T cell count of 50-199/μL and ≥200/μL was 0.442 and 0.512 compared to the cases with the count of <50/μL.Conclusion Most of the AIDS mortalities occurred during the first 6 months after the beginning of antiretroviral therapy,then the mortality decreased during the following months.Low baseline CD4+T cell count and WHO clinical stage of Ⅲ or IV are risk factors for AIDS-related death among the AIDS cases receiving antiretroviral therapy.

     

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