成年艾滋病抗病毒治疗患者生存状况及其影响因素

目的 了解成年艾滋病抗病毒治疗患者生存状况及其影响因素，为改善艾滋病患者生存状况提供参考依据。方法 收集2006年9月-2010年9月在宁夏医科大学总医院接受抗病毒治疗的152例≥ 18周岁成年艾滋病患者病历资料，分析其在观察期间的生存状况，并采用多因素Cox比例风险回归模型分析影响患者生存状况的影响因素。结果 2015年9月30日随访截止时，152例成年艾滋病抗病毒治疗患者中仍在治疗102例（67.11%），失访7例（4.61%），转诊10例（6.58%），停药5例（3.29%），死亡28例（18.42%）；28例死亡患者中，死于艾滋病者21例（75.00%），因其他因素致死者7例（25.00%）；21例死于艾滋病患者中，抗病毒治疗<1年死亡11例（52.38%），2~3年死亡7例（33.33%），4~5年死亡3例（14.29%）。多因素Cox比例风险回归分析结果显示，年龄≥30岁、WHO临床分期Ⅲ期以上、感染途径为异性和同性性途径感染是影响成年艾滋病抗病毒治疗患者生存状况的危险因素；CD4⁺细胞计数>200个/μL和抗病毒治疗方案为≥ 2种抗菌药物联合治疗是影响成年艾滋病抗病毒治疗患者生存状况的保护因素。结论 年龄、CD4⁺细胞计数、WHO临床分期、抗病毒治疗方案和感染途径是成年艾滋病抗病毒治疗患者生存状况的主要影响因素。

Survival and its influencing factors among adult AIDS patients with antiviral therapy

Objective To examine the survival and its influencing factors among adult AIDS patients with antiviral therapy and to provide references to improve living conditions of AIDS patients.Methods Medical records of 152 AIDS patients aged 18 years and above with antiviral therapy in General Hospital of Ningxia Medical University from September 2006 through September 2010 were extracted and the survival of the patients during the observation period was analyzed.Multivariate Cox proportional hazard regression model was applied to analyze factors influencing the survival of the patients.Results Of all the patients,102 (67.11%) were still under the antiviral therapy,7 (4.61%) were lost to the follow-up,10 (6.58%) were transferred to other medical institutions,5 (3.29%) ended antiviral therapy,and 28 (18.42%) were dead by the end of the follow-up on September 30,2015.Among all the dead cases,21 (75.00%) died of AIDS and 7 (25.00%) died of other causes;for the 21 cases died of AIDS,11 (52.38%),7 (33.33%),and 3 (14.29%) had the antiviral treatment duration of less than one year,2 to 3 years,and 4 to 5 years,respectively.The results of multivariate Cox proportional hazard regression analysis showed that at the age 30 years or older,with the stage III or higher World Health Organization (WHO) clinical classification,infected with human immunodeficiency virus (HIV) via heterosexual or homosexual behaviors were risk factors for mortality,whereas with the CD4⁺ cell count of more than 200/μL and with the therapeutic regimen of two or more antiviral drugs were protective factors of mortality among the adult AIDS patients.Conclusion Age,route of HIV infection,CD4⁺ cell count,antiviral treatment regimen,and WHO clinical stage are main influencing factors of survival among adult AIDS patients with antiviral therapy.