广西壮族自治区艾滋病抗病毒治疗患者CD4+T淋巴细胞动态趋势及影响因素分析

目的 了解广西壮族自治区(广西)抗病毒治疗患者CD₄⁺T淋巴细胞动态趋势及影响因素。方法 选择2013年1月1日后首次开始抗病毒治疗的成年艾滋病患者,对基线、治疗后6个月和12个月时间段的CD₄⁺T淋巴细胞计数结果进行回顾分析,采用一般线性模型重复测量方差分析描述和分析患者CD₄⁺T淋巴细胞动态趋势及影响因素。结果 4 082例患者基线、治疗后6个月和12个月的CD₄⁺T淋巴细胞计数均值分别为(195.3±155.7)cells/mm³、(331.9±202.6) cells/mm³ 和 (380.9±221.3) cells/mm³, 仅有时间效应时,总体差异有统计学意义(F=3 161.124,P=0.000)。治疗后CD₄⁺T淋巴细胞计数随时间推移而提升,主要影响因素为性别、年龄、基线CD₄⁺T淋巴细胞计数、治疗方案、漏服药物和停药。受性别、年龄、治疗方案、漏服药物、停药等因素影响,治疗后CD₄⁺T淋巴细胞计数随时间推移而呈线性提升趋势。受基线CD₄⁺T淋巴细胞计数、停药等因素影响,治疗后CD₄⁺T淋巴细胞计数提升趋势符合二次方曲线方程。结论 广西艾滋病患者抗病毒治疗后CD₄⁺T淋巴细胞计数提升速度受多种因素影响。针对不同患者适时进行抗病毒治疗可以获得良好预后结果。

Analysis on dynamic variations of CD4-Positive T-Lymphocytes counts and influencing factors among patients receiving highly active antiretroviral therapy in Guangxi Zhuang autonomous region

Objective To understand dynamic variation of CD₄-Positive T-Lymphocytes counts and influencing factors among patients receiving highly active anti-retroviral therapy (HAART) in Guangxi. Methods Adult patients who received antiviral treatment for the first time after 1 January 2013 were selected. Their CD₄-Positive T-Lymphocytes counts at baseline,6 months and 12 months after treatment were analyzed. By using the general linear model repeated measures ANOVA,CD₄-Positive T-Lymphocytes dynamic variations and influencing factors were described and analyzed. Results The average CD₄ cell counts of 4 082 patients at baseline,6^th months and 12^th months were (195.3±155.7)cells/mm³,(331.9±202.6)cells/mm³ and (380.9±221.3)cells/mm³,respectively. The time specific differences in CD₄-Positive T-Lymphocytes count among them were statistically significant(F=3 161.124,P=0.000). CD₄-Positive T-Lymphocytes counts increased over time after treatment. The main influencing factors were sex,age,baseline CD₄ cell count,medication,discontinuation of treatment or dose miss. Influenced by sex,age,medication,discontinuation of treatment or dose miss,the increased CD₄-Positive T-Lymphocytes count showed a linear trend. Influenced by baseline CD₄-Positive T-Lymphocytes counts and dose miss,the increase of CD₄-Positive T-Lymphocytes count showed a trend which was conformed to quadratic curvilinear equation. Conclusion CD₄-Positive T-Lymphocytes counts among patients receiving HAART in Guangxi were influenced by many factors. It is necessary to select the time to start treatment according to patient''s characteristics to get good outcome.