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1.
目的了解HIV感染者/AIDS患者服用抗逆转录病毒药物治疗效果、药物的不良反应及病人服药依从性。方法对接受抗HIV治疗的AIDS病人进行随机整群抽样调查随访,并进行T淋巴细胞检测。结果较早开始服用抗逆转录病毒治疗的138例患者中,58.7%的患者规范服药,41.3%的患者存在着不同程度的漏服药物现象,漏服或停药原因为忘记或药物副反应。服药后对其中的109例患者进行过两次T淋巴细胞检测,CD4 T淋巴细胞升高65例,其中升高幅度≥50个/mm349例,降低44例,其中降低幅度≥50个/mm328例。结论加强对医务人员和HIV感染者/AIDS患者抗病毒治疗知识培训,严格掌握抗逆转录病毒治疗入选标准,加强对病人的管理,提高服药依从性,是抗病毒治疗成功的关键。  相似文献   

2.
目的评价艾滋病病人服用抗病毒药物效果。方法按照国家统一的治疗方案,在知情同意的原则下,对病人给予联合高效抗逆转录病毒治疗,定期随访,采用漏服次数、CIM检测结果和临床症状改善等指标评价其依从性和治疗效果。结果当感染者的CIM细胞数低于200个/ml时,会出现发热、咳嗽、咳痰、淋巴结肿大、恶心、腹泻等症状,给予高效抗逆转录病毒治疗后,CIM细胞明显上升,体征出现转变。结论在适当的时期给予高效抗逆转录病毒治疗,可以最大限度的抑制HIV复制,使已经破坏的免疫功能部分重建,从而有效的缓解症状,延长病人的生存时间,提高生活质量。  相似文献   

3.
目的讨论HIV感染者/艾滋病病人开始抗病毒治疗时机对免疫功能重建的影响。方法对60例艾滋病病毒感染者/艾滋病病人(HIV/AIDS),采用高效联合抗逆转录病毒疗法(HAART)3个月以上,根据治疗前CD4+T细胞值分组(分组一CD4+T细胞在0~100间,分组二CD4+T细胞在100~200间,分组三CD4+T细胞在200~350间),在治疗后规定时间内采集3mL抗凝全血进行CD4+T细胞检测,统计不同治疗组CD4+T细胞变化,分析不同HAART开始时机对免疫功能重建即CD4+T细胞增长率的影响。结果 HAART不同开始时机CD4+T细胞增长率存在差异有统计学意义,分组二、分组三CD4+T细胞增长率明显且高于分组一。结论高效联合抗逆转录病毒治疗开始时机对免疫功能重建有影响。  相似文献   

4.
目的研究吉林市93例HIV感染者/AIDS病人疾病进展情况;采用高效抗逆转录病毒治疗(HAART)的疗效,为HIV/AIDS综合防治措施提供科学依据。方法通过现场流行病学调查分析HIV感染者/AIDS病人一般情况,检测抗丙型肝炎病毒(HCV)抗体,定期进行CD4+、CD8+T淋巴细胞绝对计数检测以监测疾病进展,用HAART治疗HIV感染者/AIDS病人,监测病毒学及免疫学变化,观察抗病毒药物的毒副作用及服药依从性。结果吉林市93例HIV感染者/AIDS病人中86例(92.5%)经血液感染且合并HCV感染。估计感染时间在8年以上者88例,其中20.5%CD4+T淋巴细胞数<200/mm3,50%为200~500/mm3,29.5%>500/mm3。接受HAART治疗的23例HIV感染者/AIDS病人治疗前平均病毒载量为5.06 log拷贝/ml(4.39×105拷贝/ml),治疗12个月后平均下降3.47log拷贝/ml(P<0.001),其中16例达到检测不出的水平(<400拷贝/ml),CD4+T淋巴细胞数平均上升48个/mm3(P<0.05)。结论吉林市存在部分疾病进展缓慢的HIV感染者;HAART治疗取得了较好的疗效,但司他夫定和去羟肌苷联合应用使周围神经病变发生率较高;加强对感染者疾病进展和抗病毒疗效及不良反应监测,有助于确定开始抗病毒治疗的时机和及时调整治疗方案。  相似文献   

5.
目的了解凉山地区HIV感染者/AIDS患者抗病毒治疗服药依从性现状及漏服药物的原因,并探讨其影响因素。方法通过两阶段抽样的方式抽取研究对象,采用自行设计的一般情况量表及美国社区艾滋病临床研究抗逆转录病毒药物自陈表进行问卷调查。一般资料和服药情况采用频数和构成比进行描述,影响因素分析采用卡方检验和Logistic回归分析。结果共纳入267例HIV/AIDS患者,其中237例服药依从性良好(88.76%)。漏服药物的前3大原因分别是外出(20.97%)、忘记吃药(19.35%)和不想让他人知道自己在吃药(17.74%);最常漏服药物的时间是夜晚(37.78%)。卡方检验显示,不同民族、不同地区、有和无症状的患者服药依从性之间存在差异(P0.05);Logistic回归显示,彝族患者(OR=4.202)、无症状者(OR=3.372)服药依从性更好。结论凉山地区HIV感染者/AIDS患者抗病毒治疗依从性整体水平良好,但仍有提升空间。针对漏服药物的原因及影响因素,应继续向大众普及艾滋病的知识,加强抗病毒治疗的宣传教育,倡导使用提醒服药的方法,提高患者症状管理的能力,以维持和进一步提高服药依从性。  相似文献   

6.
目的 了解河南省艾滋病病毒感染者/艾滋病患者(HIV/AIDS)高效联合抗病毒疗法(HAART)的服药依从性及其相关因素。方法 抽取了2个AIDS综合防治示范区、1个AIDS高发县。未服药和服药在2—12个月的HIV感染者作为被调查对象,分别对服药依从性、不良反应及临床表现,治疗前后临床症状改善状况及治疗保障措施等项目,通过访谈问卷调查;同时抽取静脉血,测定评价服药者CD4^ T淋巴细胞,病毒载量,用逆转录聚合酶链反应(RT-PCR)方法扩增HIV-1 POL区基因,进行基因型耐药性分析。结果 治疗组治疗时间在4—8个月的人数最多占78.24%,服药依从性达到90%~100%的占67.51%,停服和漏服药物的主要原因是不良反应占66.95%,最显著的不良反应是服药后引起的恶心、呕吐、皮疹等不适。治疗组坚持服药症状明显改善的占87.57%,停服和漏服药症状未明显改善的占11.01%。服药依从性对病情趋势变化具有显著影响(P<0.05)。治疗组服药后CD4^ T细胞总数保持稳定或有所增加,但实际速度较缓慢。抗病毒治疗3个月和6个月时,患者的病情好转率分别是55.1%和50.8%,CD4^ T细胞数较未服药治疗的患者显著提高。耐药性毒株的流行率显著增加,由未服药人群的13.9%快速上升到服药3个月的45.4%和服药6个月的62.7%,其中对非核苷类逆转录酶抑制剂(NNRTI)类药物耐药性的增加最为明显,导致中高度以上耐药率的显著增加。结论 采取有效的抗病毒治疗以后,HIV/AIDS患者在接受抗病毒治疗过程中,服药依从性直接关系治疗效果以及对治疗计划的实施。避免耐药毒株的出现,必须提高服药依从性,这对今后评价治疗效果具有重要意义。  相似文献   

7.
姜楠 《中国公共卫生》2005,21(8):942-943
目的了解HIV携带10年者T淋巴细胞亚群现状,制订救治方案,指导高效抗逆转录病毒治疗。方法采用美国FACSCount流行细胞仪,检测HIV感染者外周血中CD4、CD8T细胞绝对值数。结果检测HIV感染者836例,CD4淋巴细胞<200/mm3者180例,占21·53%;CD4T淋巴细胞>200/mm3者656例,占78·7%。CD4/CD8<1者779例,CD4/CD8>1者57例。结论长期存活的HIV感染者CD4T淋巴细胞计数10年内保持在正常范围之内;部分感染者已进入AIDS期。在无症状的HIV感染者中存在免疫力极度低下者,由高水平的T淋巴细胞的抗病毒作用而使其处于无症状期。  相似文献   

8.
吴科明  阮姨 《职业与健康》2012,28(1):76-77,81
目的通过对HIV感染者/AIDS患者的高效抗逆转录病毒治疗(HARRT),观察CD4+T淋巴细胞绝对计数及CD4+T/CD8+T比值,分析抗病毒治疗的效果。方法检测治疗前后CD4+T淋巴细胞绝对计数及CD4+T/CD8+T比值,运用统计学方法对数据进行处理。结果 96例血标本抗病毒治疗前后CD4+T计数分别为(102.63±28.57)和(249.41±23.95)个/μl;CD4+T/CD8+T比值分别为(0.23±0.19)和(0.42±0.23),治疗效果明显,无论男性、女性治疗都是有效的;在无症状或出现较轻症状HIV感染者的治疗效果比疾病严重或较重者好。结论 HARRT的治疗效果明显,可提高HIV感染者/AIDS患者抗病毒治疗的比例,延缓疾病进程和降低病死率。  相似文献   

9.
高效抗逆转录病毒治疗(HAART)显著降低了人免疫缺陷病毒(HIV)感染者和艾滋病(AIDS)患者的机会性感染发生率,接受治疗者的CD4T细胞计数增加表明其免疫功能已有提高。HAART使HIV/AIDS相关的真菌感染率由90年代中期的25%下降到现在的20%,耐咪唑类药的白色念珠菌和曲霉菌引起的机会性感染很少出现于HIV感染者,而HIV合并真菌感染者在接受HAART后也不需要超长时间的抗真菌治疗。随着HAART的有效应用,HIV/AIDS相关机会性感染将得到显著的控制。  相似文献   

10.
目的 评价HIV感染者/艾滋病患者(HIV/AIDS)抗病毒治疗效果,为抗病毒治疗提供依据.方法 采用回顾性队列研究方法,对江都区2006年3月-2012年12月加入治疗的69例HIV/AIDS进行随访观察,观察截止于2013年12月.记录随访期间患者CD4+T细胞计数和病毒载量检测数据,及死亡、退出治疗等情况.结果 治疗1年后病毒抑制比例为68.85%;随着治疗时间的延长,CD4+T细胞计数逐渐增长,治疗3年较治疗前平均增长266/mm3;治疗前后CD4+T细胞计数变化差异均有统计学意义(P值均<0.01);治疗3年生存率为92.74%.结论 HIV/AIDS抗病毒治疗效果较理想,早发现早治疗、扩大治疗覆盖面、提高患者服药依从性可提高治疗效果.  相似文献   

11.
Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.  相似文献   

12.
This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.  相似文献   

13.
深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.  相似文献   

14.
Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO2) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO2. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO2 at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO2 gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO2 also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO2.  相似文献   

15.
Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L?1 to a maximum of 79?mg·L?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.  相似文献   

16.
The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.  相似文献   

17.
Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).  相似文献   

18.

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.  相似文献   

19.
20.
The repeatability and validity of a questionnaire for upper limb and neck complaints were assessed in a population of 105 hospital outpatients with a range of upper limb and neck disorders (including cervical spondylosis, adhesive capsulitis, lateral epicondylitis, carpal tunnel syndrome and Raynaud's phenomenon). Subjects were asked to complete a modified Nordic-style upper limb and neck discomfort questionnaire on two occasions closely spaced in time. The repeatability of their responses was assessed by calculating a kappa coefficient (kappa), and the sensitivity and specificity of component items in the questionnaire were determined for specific diagnostic categories of upper limb and neck disorder. Symptom reports for pain in the upper limb and neck, pain interfering with physical activities, neurological symptoms and blanching were all found to be highly repeatable (kappa = 0.63-0.90). A number of regional pain reports proved to be very sensitive in relation to specific upper limb disorders, but, with the exception of reported finger blanching in patients with Raynaud's phenomenon, none proved to have a good specificity (range = 0.33-0.38). We conclude that a modified Nordic-style questionnaire is repeatable and sensitive, and is likely to have a high utility in screening and surveillance. However a complementary examination schedule of adequate specificity and repeatability is essential to establish a clinical diagnosis.  相似文献   

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