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目的了解浦东新区医学随访管理艾滋病毒感染者/艾滋病患者(HIV/AIDS)的早治疗情况,分析在不同CD4~+T淋巴细胞计数水平下启动高效抗逆转录病毒治疗(HAART)后的免疫重建效果。方法采用历史队列研究的方法,收集2004年1月至2016年7月期间在上海市浦东新区启动HAART的HIV/AIDS人群的人口学特征、CD4~+T淋巴细胞检测时间、检测结果等信息进行统计描述与分析。结果共入组953名对象,研究对象启动HARRT时的CD4~+T淋巴细胞计数水平呈逐年升高的趋势,早治疗的比例逐年升高。CD4~+T淋好巴细胞计数随着治疗时间的延长而增加,基线CD4~+T淋巴细胞计数在500个/μL以下对象的CD4~+T淋巴细胞计数与治疗时间呈明显的线性关系,对象之间的CD4上升幅度比较接近;基线CD4~+T淋巴细胞计数>500个/μL对象的CD4~+T淋巴细胞计数与治疗时间呈不明显的线性关系,治疗12个月后CD4的上升幅度有所下降。基线CD4~+T淋巴细胞计数水平较高的对象启动HAART后CD4~+T淋巴细胞计数也始终维持在较高水平。结论晚治疗HIV/AIDS的免疫功能虽然可以不断恢复,但免疫状态始终处于相对较低的水平,通过早治疗可以一直保持较高的免疫水平,因此应进一步提高早治疗的比例。
Objective To understand the early treatment of HIV / AIDS patients in medical follow-up in Pudong New Area and analyze the immune reconstructions after initiating HAART with different CD4 ~ + T lymphocyte counts effect. Methods A historical cohort study was conducted to collect demographic characteristics, CD4 ~ + T lymphocyte detection time and test results from January 2004 to July 2016 in HIV / AIDS patients who started HAART in Shanghai Pudong New Area Statistical description and analysis. Results A total of 953 subjects were enrolled in this study. The CD4 ~ + T lymphocyte counts of patients with HARRT at baseline were increasing year by year. The proportion of early treatment increased year by year. CD4 ~ + T lymphocyte count increased with the extension of treatment time, the baseline CD4 ~ + T lymphocyte counts in 500 / L following CD4 ~ + T lymphocyte count and treatment time showed a significant linear relationship, There was no obvious linear relationship between the CD4 ~ + T lymphocyte count and the treatment time in subjects with CD4 ~ + T lymphocyte count> 500 cells / μL. The increase of CD4 after 12 months of treatment The rate has dropped. The CD4 ~ + T lymphocyte counts of subjects with higher baseline CD4 ~ + T lymphocyte count after starting HAART were also maintained at higher levels. Conclusion Although the immune function of late treatment of HIV / AIDS can be continuously restored, the immune status is always at a relatively low level. Early treatment can maintain a high level of immunity, so the proportion of early treatment should be further improved.