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目的分析新疆伊宁市2006-2015年艾滋病病毒(HIV)感染者和艾滋病(AIDS)患者的生存时间及其影响因素。方法运用回顾性队列研究方法,对2006-2015年中国艾滋病综合防治信息管理系统中报告的伊宁市6 437例HIV/AIDS患者数据资料进行分析,引用寿命法计算研究对象的生存率,采用Kaplan-Meier法和Cox比例风险模型分析研究对象生存时间的影响因素。结果 6 437例研究对象中,1 016例(15.8%)死于艾滋病相关疾病,接受抗病毒治疗3 687例(57.3%)。平均生存时间为100.0(98.9~101.1)个月,1、3、5、7、9年的生存率分别为93.0%、86.0%、82.0%、80.0%、78.0%。单因素分析结果显示,性别、年龄、民族、文化程度、感染途径、诊断时的病程、最近一次CD4~+T淋巴细胞检测结果,是否接受抗病毒治疗是生存时间的影响因素;多因素分析结果显示,诊断时年龄在45岁以下(与18~29岁相比:HR=0.339,95%CI:0.172~0.665;与30~岁相比:HR=0.800,95%CI:0.666~0.961)、诊断时病程为HIV感染阶段(HR=0.334,95%CI:0.270~0.412)、最近1次CD4~+T淋巴细胞检测结果≥350个/μl(HR=0.281,95%CI:0.222~0.356)可以降低艾滋病患者因艾滋病死亡的风险;未接受抗病毒治疗因艾滋病死亡的风险(HR=0.243,95%CI:0.204~0.290)高于接受抗病毒治疗的艾滋病患者。结论诊断时的年龄、所处的病程、CD4~+T淋巴细胞水平和是否接受抗病毒治疗影响艾滋病病毒感染者和艾滋病患者的生存时间;艾滋病患者应及早接受抗病毒治疗,可以延长生存时间。
Objective To analyze the survival time and its influential factors of HIV infected persons and AIDS patients in Yining, Xinjiang from 2006 to 2015. Methods A retrospective cohort study was conducted to analyze the data of 6 437 HIV / AIDS patients reported in China AIDS Integrated Prevention and Control Information System from 2006 to 2015. Life expectancy was calculated by using life expectancy method. Kaplan-Meier method -Meier method and Cox proportional hazards model to analyze the influencing factors of the survival time of the subjects. Results Of 6 437 study subjects, 1 016 (15.8%) died of AIDS-related diseases and 3 687 (57.3%) received anti-viral therapy. The average survival time was 100.0 (98.9 ~ 101.1) months. The survival rates at 1, 3, 5, 7 and 9 years were 93.0%, 86.0%, 82.0%, 80.0% and 78.0%, respectively. Univariate analysis showed that gender, age, ethnicity, educational level, pathways of infection, the course of diagnosis, the results of the latest CD4 ~ + T lymphocyte test, and whether or not antiviral treatment were the influencing factors of survival time were the factors influencing the survival time. The results of multivariate analysis Showed that the age at diagnosis was 45 years or younger at the time of diagnosis (compared with 18 to 29 years old: HR = 0.339, 95% CI: 0.172 to 0.665; HR: 0.800, 95% CI: The duration of diagnosis was HIV infection stage (HR = 0.334, 95% CI: 0.270-0.412). The results of the last CD4 + T lymphocyte test were ≥350 / μl (HR = 0.281, 95% CI: 0.222~0.356) Can reduce the risk of AIDS deaths in AIDS patients; the risk of death from AIDS without antiviral therapy (HR = 0.243, 95% CI: 0.204-0.290) is higher than that of AIDS patients receiving antiviral therapy. Conclusions The age at diagnosis, the course of the disease, the level of CD4 ~ + T lymphocytes and whether or not antiviral treatment affects the survival of HIV-infected and AIDS-infected patients; AIDS patients should be treated with antiviral therapy as early as possible to prolong their survival time.