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目的了解贵州省人类免疫缺陷病毒(HIV)感染者和艾滋病(AIDS)患者接受抗逆转录病毒治疗后的生存时间及其影响因素。方法采用回顾性队列研究方法,分析贵州省2005—2016年接受抗病毒治疗的AIDS患者的生存时间,应用寿命表法计算生存概率,运用Cox比例风险回归模型分析其影响因素。结果共纳入分析15921例AIDS患者,开始治疗时的平均年龄为(42.13±14.40)岁,已婚/同居者占58.61%。治疗后患者的随访时间[中位数(P25~P75):15.96(6.00~33.00)]月。9.77%随访病例发生死亡,其中59.29%的死亡发生在开始治疗的12个月内;第1、5、10年的生存率分别为93.00%,82.00%和74.00%。Cox比例风险回归模型分析结果显示:女性患者死亡风险是男性的0.58倍(95%CI:0.49~0.68);随着年龄增高,患者死亡风险亦增高;基线CD4+T淋巴细胞计数越高,患者死亡风险越低;治疗前无疾病症状体征的患者死亡风险是有症状体征的0.70倍(95%CI:0.60~0.81)。结论贵州省AIDS患者抗病毒治疗情况整体较好,应高度关注死亡危险因素较高的患者,建议在扩增治疗患者的同时注重提高医疗水平和服务质量。
Objective To investigate the survival time and its influencing factors of anti-retroviral therapy in HIV-infected and AIDS-infected patients in Guizhou Province. Methods A retrospective cohort study was conducted to analyze the survival time of AIDS patients receiving ART from 2005 to 2016 in Guizhou Province. Life expectancy was calculated by life table method, and the influencing factors were analyzed by Cox proportional hazards regression model. Results A total of 15921 AIDS patients were included in the analysis. The mean age at the initiation of treatment was (42.13 ± 14.40) years old, with 58.61% married / cohabited. Follow-up of patients after treatment [median (P25-P75): 15.96 (6.00-33.00)] months. The deaths occurred in 9.77% of follow-up cases. Of them, 59.29% of deaths occurred within 12 months after initial treatment. The survival rates at 1, 5 and 10 years were 93.00%, 82.00% and 74.00% respectively. Cox proportional hazards regression analysis showed that the risk of death was 0.58 times higher in men than in men (95% CI: 0.49-0.68). With age, the risk of death was also increased. The higher the baseline CD4 + T lymphocyte count, The lower the risk of death, the risk of death was 0.70 times as high as the symptomatic (95% CI: 0.60 to 0.81) for patients without symptom signs before treatment. Conclusion AIDS patients in Guizhou Province have a good overall antiviral treatment and should pay more attention to patients with higher risk of death. It is suggested that patients should be treated with amplification in order to improve medical care and quality of service.