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目的了解河南省某县抗人类免疫缺陷病毒(HIV)治疗病人耐药毒株产生的影响因素。方法对河南省某县抗HIV治疗病人进行队列研究,采用问卷调查和实验室检测耐药性结合的方法,用寿命表方法计算累积耐药率,用COX回归方法分析耐药性产生的影响因素。结果河南省某县艾滋病患者抗病毒治疗时间为182.5,365,547.5,730d,累积耐药率分别为19.0%,35.8%,41.7%,48.2%。家庭人均月收入高、医生经常主动询问服药后情况和已婚是影响耐药产生的保护性因素,而治疗前有临床症状和3 d内漏服治疗药物是耐药产生的危险因素。结论应加大医疗救助、抗病毒治疗督导与管理、加强病人关怀等方面的力度,努力提高病人服药的依从性,以减缓耐药毒株的产生。
Objective To understand the influencing factors of drug-resistant strains of anti-human immunodeficiency virus (HIV) in a county of Henan Province. Methods A cohort study was conducted in anti-HIV treatment patients in a county of Henan Province. Cumulative resistance rates were calculated by questionnaires and laboratory tests of drug resistance. Life expectancy measures were used to calculate cumulative resistance rates. COX regression was used to analyze the influencing factors of drug resistance . Results The HIV-infected patients in a county of Henan province had antiviral treatment time of 182.5, 365, 547.5 and 730 days, and the cumulative drug-resistant rates were 19.0%, 35.8%, 41.7% and 48.2%, respectively. High per capita monthly income of families, doctors often take the initiative to ask about the situation after medication and married are protective factors that affect the resistance, and clinical symptoms before treatment and 3 days of missed medication is a risk factor for drug resistance. Conclusion Medical supervision should be stepped up, supervision and management of antiviral therapy should be stepped up, patient care should be strengthened, and efforts should be made to improve the patient’s medication compliance so as to reduce the generation of drug-resistant strains.