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目的分析广东省艾滋病患者接受抗病毒治疗后的生存状况,探讨影响患者治疗后生存时间的因素。方法利用国家统一使用的成人DataFax抗病毒治疗信息收集系统所收集的全省抗病毒治疗数据资料,采用COX比例风险模型对影响广东省艾滋病患者抗病毒治疗后生存时间的因素进行分析。结果共有1 307例接受抗病毒治疗的艾滋病患者纳入分析,其中66.7%的患者在出现艾滋病相关症状后才被检测出H IV阳性;52.3%开始治疗时已经进入临床Ⅲ期,29.9%进入了临床Ⅳ期;88.2%的人开始治疗时CD4+T细胞低于200个/μL。1 307例中死亡80例(6.1%),停药37例(2.8%),失访227例(17.4%),继续治疗963例(73.7%)。80例死亡者中治疗后生存时间最短的只有2 d,最长的3年多,92.5%的死亡发生在治疗后的1年内;963例仍在继续治疗,其中108例(11.2%)治疗已达3年以上。影响患者治疗后生存时间的保护因素是当需要时及时更换方案(RR=0.205)和治疗开始时较高的CD4+T细胞水平(RR=0.341),危险因素为较多的机会性感染(RR=1.149)。结论需要进一步采取措施以监测患者的CD4+T变化及机会性感染情况,及时收治患者,积极预防机会性感染的发生,同时应着重提高治疗者的服药依从性教育,及时监测患者的服药情况,必要时及时调整方案,尽可能延长患者治疗时间。
Objective To analyze the living conditions of AIDS patients receiving antiviral therapy in Guangdong Province and to explore the factors influencing their survival time after treatment. Methods The data of anti-virus treatment data collected by the adult DataFax antiviral treatment information collection system used by the nation were used to analyze the factors influencing the survival time of patients with AIDS after anti-virus treatment in Guangdong Province using COX proportional hazard model. Results A total of 1,307 AIDS patients treated with antiviral therapy were included in the analysis. 66.7% of them were positive for HIV-1 in the presence of AIDS-related symptoms. 52.3% of patients started clinical phase III and 29.9% entered the clinical trial Ⅳ; 88.2% of the people started treatment CD4 + T cells below 200 / μL. Of the 307 patients, 80 (6.1%) died, 37 (2.8%) were discontinued, 227 (17.4%) were lost and 963 (73.7%) were treated. Among the 80 deaths, the shortest survival time after treatment was only 2 days, the longest more than 3 years, and 92.5% of deaths occurred within 1 year after treatment. Of the 963 patients who were still undergoing treatment, 108 (11.2%) had been treated Up to 3 years. The protective factors influencing the survival time of patients after treatment were timely replacement plan (RR = 0.205) and higher CD4 + T cell level (RR = 0.341) at the beginning of treatment when needed, and the risk factors were more opportunistic infections = 1.149). Conclusion It is necessary to take further measures to monitor the changes of patients with CD4 T and opportunistic infections, timely treatment of patients, and actively prevent the occurrence of opportunistic infections, and should focus on improving the treatment of drug compliance education, timely monitoring of patient medication, If necessary, timely adjustment of programs, as far as possible to extend the treatment of patients.