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目的了解广东省是否需要治疗及治疗与否的艾滋病感染者/患者(HIV/AIDS)的生存时间,探讨影响HIV/AIDS生存时间的风险因素。方法采用回顾性队列研究。研究对象来自中国疾病预防控制信息系统/艾滋病综合防治信息系统/HIV/AIDS病例报告;纳入研究的对象为在2004年1月至2014年6月间报告的、现住址在广东省的、非港澳台及外籍的年龄在15岁以上的HIV/AIDS。采用乘积-极根法绘制4组生存曲线,用log-rank检验对多组生存曲线比较,多因素Cox比例风险模型对影响HIV/AIDS生存时间的风险因素进行分析。结果符合条件的HIV/AIDS病例共36 500例,最终纳入分析28 474例,男女性别比为3.54∶1,年龄以15~39岁为主(68.78%),婚姻状况以已婚为主(44.02%),传播途径以异性为主(55.33%),需要治疗的占71.68%,已治疗的有53.50%。8年生存率由高到低依次是不需治已治组(88.68%)、需治已治组(79.07%)、不需治未治组(70.14%)及需治未治组(42.92%)。4组生存曲线差异具有统计学意义(P<0.01)。多因素Cox比例风险模型结果显示,男性的死亡风险是女性的1.42倍,15岁以上的病例每增加10岁死亡风险增加0.60倍,异性传播的死亡风险是同性传播的5.66倍,注射毒品传播的死亡风险是同性传播的9.60倍,首次检测CD4+T细胞计数分组中,相对于<200个/mm3,200个/mm3及以上各组的死亡风险由0.43倍逐渐降低到0.26倍。结论对HIV/AIDS病例进行治疗可以延长其生存时间,及早进行CD4+T细胞计数检测以明确病程,为是否开始艾滋病抗病毒治疗提供依据。
Objective To understand the survival time of HIV / AIDS patients in need of treatment and treatment in Guangdong Province and to explore the risk factors influencing the survival time of HIV / AIDS patients. Methods Retrospective cohort study. The subjects were from China Disease Control and Prevention Information System / Integrated HIV / AIDS / HIV / AIDS Case Reports; the subjects of the study were reported from January 2004 to June 2014, and the current addresses were in Guangdong Province, Taiwan and foreign countries over the age of 15 HIV / AIDS. The survival curves of four groups were plotted by product-root method. The multiple survival curves were compared by log-rank test and the risk factors influencing the survival time of HIV / AIDS were analyzed by multivariate Cox proportional hazard model. Results A total of 36 500 HIV / AIDS cases were eligible and 28 474 cases were finally analyzed. The male / female ratio was 3.54:1. The age was mainly 15-39 years old (68.78%). Marital status was mainly married (44.02 %). The main route of transmission was heterosexuality (55.33%), 71.68% needed treatment, and 53.50% had treatment. The 8-year survival rate from high to low was no need to rule the rule group (88.68%), need to rule the rule group (79.07%), need to rule the rule group (70.14%) and need to rule the rule group (42.92% ). There were significant differences in survival curves between the four groups (P <0.01). The multivariate Cox proportional hazards model showed that the risk of death in men was 1.42 times that of women and the risk of death increased by 0.60 times for each additional 10 years old in cases over 15 years of age. The risk of death from heterosexual transmission was 5.66 times that of homosexual transmission. The risk of death was 9.60 times that of same-sex transmission. In the first CD4 + T cell count test, the risk of death was reduced from 0.43 to 0.26 times relative to <200 / mm 3, 200 / mm 3 and above. Conclusions The treatment of HIV / AIDS patients can prolong their survival time, detect the CD4 + T cell count as early as possible to determine the course of the disease, and provide the basis for whether or not to start AIDS anti-virus therapy.