云南省瑞丽市静注毒品人群HIV感染者死亡情况调查

采用回顾性前瞻研究对１９８９年１０月～１９９３年１０月瑞丽市静注毒品人群ＨＩＶ感染者死亡情况进行调查。在观察期内，３９５名ＨＩＶ阳性队列中死亡６１人，累计死亡率１５．４％；对照组１９２名ＨＩＶ阴性静注毒品队列死亡１８人，累计死亡率９．４％，两相比较差异显著（Ｐ＜０．０５），相对危险度（ＲＲ）１．６（９５％可信区间１．０～２．５）。按死因分类后，两队列死因不明和意外死亡类别差异不显著（Ｐ＞０．０５），且均保持较高的主要为由吸毒过量、殴斗自杀行为所致的意外性死亡率（分别为４．７％、５．８％）。但是，在因病死亡类别，ＨＩＶ阳性队列死亡率为８．４％，显著高于ＨＩＶ阴性队列３．１％的水平（Ｐ＜０．０５），ＲＲ为２．７（９５％可信区间２．１～６．１）。若去除ＨＩＶ阳性队列中２名ＡＩＤＳ死亡病例后，比较两队列非ＡＩＤＳ性死亡率，ＨＩＶ阳性队列为１３．９％，ＨＩＶ阴性队列为７．９％，差异显著（Ｐ＜０．０５），ＲＲ为１．７（９５％可信区间１．０～２．８）。结果表明，瑞丽市的静注毒品者中，ＨＩＶ阳性人群死于疾病的机会较ＨＩＶ阴性人群高，其中可能包括部分漏报的ＡＩＤＳ病例，提示今后应加强对基层卫生人员有关ＡＩＤＳ诊断标准的培训。

Investigation of Mortality Among HIV-Infected Intravenous Drug Users in Ruili Region of Yunnan Province

The investigation of death condition of HIV infected intravenous drug users (IVDU) was conducted with a retrospective cohort study in Ruili city of Yunnan province from 1989-Oct to 1993-Oct, the deaths among 395 HIV+IVDUs add up to 61 and the mortality is 15.4%, which has significant difference compared to the death level of control cohort composed by 192 HIV-IVDUs (add up to 18). The relative risk of death is 1.6 (95% confidence interval 1.0~2.5). After classified by the cause of death, it was found that both maintain high accidence mortality caused mainly by narcotism, violence and suicide. But in death group caused by diseases, the mortality of HIV+IVDU (8.4%) is much higher than HIV-IVDU (3.1%) (95% confidence interval 1.2~6.1). We also compared non -AIDS mortality between HIV+ and HIV-IVDU according to data of HIV/AIDS survellance which showed 2 patients died of AIDS in HIV+ IVDU. The difference is also significant (13.8% in HIV+, but 7.9% in HIV-IVDU) and the relative risk is 1.7 (95% confidence interval 1.0~2.8). The results indicated that the lever of reported AIDS cases were probably lower than that of actual AIDS cases existing.