抗病毒治疗对老年艾滋病患者生存影响分析

目的了解抗病毒治疗对老年艾滋病患者生存的影响。方法采取回顾性队列研究,选择2005²013年百色市460例60岁及以上的老年艾滋病患者为研究对象,其中209例接受抗病毒治疗,251例未接受抗病毒治疗,运用SPSS21.0统计软件,Kaplan-Meier进行生存比较分析,COX比例风险模型进行生存影响分析。结果老年艾滋病患者抗病毒治疗组和未治疗组艾滋病相关病死率分别为5.34/100人年和19.21/100人年,抗病毒治疗对60岁2013年百色市460例60岁及以上的老年艾滋病患者为研究对象,其中209例接受抗病毒治疗,251例未接受抗病毒治疗,运用SPSS21.0统计软件,Kaplan-Meier进行生存比较分析,COX比例风险模型进行生存影响分析。结果老年艾滋病患者抗病毒治疗组和未治疗组艾滋病相关病死率分别为5.34/100人年和19.21/100人年,抗病毒治疗对60岁^、65岁、65岁^、70岁、70岁^年龄组的生存影响高于未治疗组,其死亡风险比分别为0.255、0.445和0.309,但对75岁及以上年龄组的生存影响差异无统计学意义。当引入CD4+T淋巴细胞计数水平时,年龄在65岁及以上且CD4+≤100个/mm3的患者抗病毒治疗对其生存的影响差异无统计学意义。结论抗病毒治疗对老年艾滋病患者的生存影响是显著的,提高了患者的生存率,但对于高年龄低CD4+计数水平的患者生存影响作用并不显著,从减轻患者及其家庭经济负担,减轻患者服药、就诊等医疗负担,节约医疗卫生资源的角度考虑,对年龄在65岁及以上且CD4+T淋巴细胞计数≤100个/mm3患者和75岁及以上的老年艾滋病患者,可考虑放弃接受艾滋病的抗病毒治疗,而重点做好机会性感染的预防和治疗及临终关怀工作。

The impact of antiviral therapy on the survival of elderly patients with AIDS

Objective To understand the antiviral treatment effect on survival of elderly patients with AIDS. Methods A retrospective cohort study was performed.2005-2013 a total of 460 patients with AIDS aged 60 years or more in Baise city were enrolled in this study,of which 209 cases received antiretroviral thera-py,25 1 cases did not receive antiretroviral therapy.A survival comparative analysis with Kaplan-meier,and a survival impact analysis with COX proportional hazard model were conducted by using SPSS21.0 statistical software. Results Antiviral treatment group and the untreated group elderly patients had AIDS-related mortality rates of 5.34 /100 and of 1 9.21 /100 person-years,respectively.On 60 -,65 -,70 - age group patients,the survival rate of antiviral treatment group was higher than that of untreated group,their death risk ratios were 0.255,0.445 and 0.309,respectively.But there was not significant difference in survival effect on the age group over 75 years old.When the level of CD4^ ＋ T lymphocyte count was introduced,there was not significant difference while comparison of survival rates between patients aged 65 years old or more and with CD4^ ＋ ≤ 100 cells/mm3 receiving antiviral treatment and patients without antiviral treatment. Conclusion Impact of antiretroviral therapy on the survival of elderly patients with AIDS are significant,which increases the survival rate of patients.But for the elderly patients （≥65 years）with low CD4^ ＋ count levels,antiretrovi-ral therapy cannot influence survival,from points of view of alleviating the financial burden of patients and their families,reducing patient medication,treatment and other medical burden,saving medical and health re-sources,for patients aged ≥65 years with CD4^ ＋ T lymphocyte count ≤100 cells/mm3 and patients aged ≥75 years with AIDS,it may be considered acceptable to abandon anti-viral treatment of AIDS,and to focus on opportunistic infection prevention and treatment and hospice care.