台州市HIV感染者高血压治疗率与控制率现状

徐小慧; 陈潇潇; 林海江; 高眉扬; 何纳; 丁盈盈

doi:10.16462/j.cnki.zhjbkz.2020.07.008

台州市HIV感染者高血压治疗率与控制率现状

doi: 10.16462/j.cnki.zhjbkz.2020.07.008

1.
200032 上海, 复旦大学公共卫生学院流行病学教研室, 公共卫生安全教育部重点实验室
2.
318000 台州, 台州市疾病预防控制中心性艾科

基金项目:

国家自然科学基金 81872671

国家科技重大传染病项目 2018ZX10721102-004

详细信息

通讯作者:
丁盈盈, E-mail:dingyy@fudan.edu.cn

中图分类号: R512.91
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- 被引次数: 0
出版历程
- 收稿日期: 2020-02-22
- 修回日期: 2020-04-25
- 刊出日期: 2020-07-10

Hypertension treatment and control rates among HIV-infected individuals in Taizhou City

1.
Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory for Public Health Safety of Ministry of Education, Shanghai 200032, China
2.
STD/AIDS department, Taizhou Municipal Center for Disease Control and Prevention, Taizhou 318000, China

Funds:

National natural Science Foundation of China 81872671

China National Science and Technology Major Projects on Infectious Diseases 2018ZX10721102-004

More Information

Corresponding author: DING Ying-ying, E-mail:dingyy@fudan.edu.cn

摘要

摘要: 目的了解台州市人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染者高血压治疗与控制现状，为针对性开展高血压控制工作提供依据。方法基于2017年“HIV与衰老相关疾病前瞻性队列研究”的基线数据，于2019年9―12月对到台州市各区县疾病预防控制中心符合基线高血压标准的242名HIV感染者进行问卷调查和体格检查。结果本次调查时，HIV感染者的高血压治疗率和控制率分别为44.2%和54.5%。年龄≥45岁、有高血压家族史以及合并高血脂的病人高血压治疗率较高（均有P < 0.05）；未接受治疗者高血压控制率高于采用药物治疗者（χ²=12.067，P < 0.001）；接受治疗者高血压控制率影响因素为有高血压家族史（aOR=0.153，95% CI：0.055~0.420）、基线调查时为轻度（aOR=0.130，95% CI：0.041~0.406）或中重度高血压（aOR=0.263，95% CI：0.075~0.915）；未接受治疗者高血压控制率影响因素为抗病毒治疗时间≥6年（aOR=0.355，95% CI：0.165~0.765）；单一用药与联合用药者高血压控制率差异无统计学意义。结论 HIV感染者的高血压治疗率和控制率有待提高。应加强该人群血压监测和管理工作，并进一步研究HIV感染合并高血压者的治疗方案。
- HIV感染 /
- 高血压 /
- 治疗率 /
- 控制率
Abstract: Objective To investigate the treatment and control rates of hypertension among HIV-infected individuals in Taizhou City and provide evidences for prevention and control of hypertension. Methods Data was assessed from baseline survey of Comparative HIV and Aging Research in Taizhou (CHART) in 2017 and HIV-infected individuals who met diagnostic standard of hypertension at baseline were surveyed when they came to local Centers for Disease Control and Prevention to receive regular follow-up medical care and assessment, between September and December 2019. Questionnaire interview and physical examination were carried out. Results Rates of hypertension treatment and control were 44.2% and 54.5%, respectively. The rate of hypertension treatment were significantly higher among those aged over 45 years, with family history of hypertension and hyperlipemia (all P < 0.05). The rate of hypertension control was significantly lower among those on antihypertensive therapy than those without antihypertensive therapy (χ²=12.067, P < 0.001). Among those on antihypertensive therapy, family history of hypertension (aOR=0.153, 95% CI:0.055-0.420) and have been diagnosed with mild (aOR=0.130, 95% CI:0.041-0.406) or moderate and severe hypertension (aOR=0.263, 95% CI:0.075-0.915) at baseline were significantly associated with rate of hypertension control, whereas among those without antihypertensive therapy, only the time of antiviral treatment ≥ 6 years (aOR=0.355, 95% CI:0.165-0.765) was significantly associated with rate of hypertension control. No significance difference in hypertension control was found between those using single treatment drug and those using combined treatment drugs. Conclusions The hypertension treatment and control rates among HIV-infected individuals in Taizhou City remain to be improved. There is an urgent need for blood pressure screening and treatment management among HIV-infected individuals. Further research is needed to develop the effective hypertension treatment strategies for this population.
- HIV infection /
- Hypertension /
- Treatment rate /
- Control rate

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表 1 不同特征HIV感染者高血压的治疗率和控制率

Table 1. Treatment and control rates of hypertension among HIV-infected individuals according to sociodemographic and clinical characteristics

变量	合计(n)	治疗率(治疗人数/总人数[%(n/N)]	χ²值	P值	未治疗组高血压控制率(控制人数/未治疗人数)[%(n/N)]	χ²值	P值	治疗组高血压控制率(控制人数/治疗人数)[%(n/N)]	χ²值	P值
年龄(岁)			27.587	< 0.001		0.582	0.446		0.163	0.687
< 45	51	11.8(6/51)			68.9(31/45)			50.0(3/6)
≥45	191	52.9(101/191)			62.2(56/90)			41.6(42/101)
性别			1.503	0.220		0.155	0.694		0.051	0.822
女	48	52.1(25/48)			60.9(14/23)			44.0(11/25)
男	194	42.3(82/194)			65.2(73/112)			41.5(34/82)
个人年收入(元)			0.812	0.666		0.664	0.717		0.530	0.767
< 10 000	63	39.7(25/63)			60.5(23/38)			36.0(9/25)
10 000~	85	47.1(40/85)			68.9(31/45)			45.0(18/40)
≥30 000	94	44.7(42/94)			63.5(33/52)			42.9(18 /42)
吸烟			1.744	0.187		1.978	0.160		0.774	0.379
否	161	47.2(76/161)			60.0(51/85)			44.7(34/76)
是	81	38.3(31/81)			72.0(36/50)			35.5(11/31)
饮酒			0.381	0.537		0.123	0.726		0.016	0.900
否	160	45.6(73/160)			65.5(57/87)			42.5(31/73)
是	82	41.5(34/82)			62.5(30/48)			41.2(14/34)
BMI(kg/m²)			1.012	0.315		0.237	0.627		0.994	0.319
< 24	151	41.7(63/151)			65.9(58/88)			46.0(29/63)
≥24	91	48.4(44/91)			61.7(29/47)			36.4(16/44)
腹部肥胖			3.023	0.082		0.750	0.388		2.981	0.084
无	126	61.1(77/126)			67.5(52/49)			51.0(25/77)
有	116	50.0(58/116)			60.3(35/58)			34.5(20/58)
饮食偏咸			1.085	0.581		0.561	0.755		3.360	0.186
清淡	54	48.2(26/54)			64.3(18/28)			53.9(14/26)
一般	75	46.7(35/75)			60.0(24/40)			45.7(16/35)
偏咸	113	40.7(46/113)			67.2(45/67)			32.6(15/46)
经常锻炼			3.007	0.083		0.072	0.788		0.024	0.877
否	146	39.7(58/146)			63.6(56/88)			41.4(24/58)
是	96	51.0(49/96)			66.0(31/47)			42.9(21/49)
糖尿病患病^a			2.517	0.113		1.740	0.187		1.555	0.212
否	211	43.1(91/211)			65.8(79/120)			39.6(36/91)
是	27	59.3(16/27)			45.5(5/11)			56.3(9/16)
高血脂			14.622	< 0.001		0.157	0.687		0.636	0.425
否	212	39.6(84/212)			64.1(82/128)			44.1(37/84)
是	30	76.7(23/30)			71.4(5/7)			34.8(8/23)
高血压家族史			7.228	0.007		1.271	0.260		11.432	< 0.001
否	123	35.8(44/123)			68.4(54/79)			61.4(27/44)
是	119	52.9(63/119)			58.9(33/56)			28.6(18/63)
医疗保险			1.474	0.225		0.093	0.762		1.860	0.173
不参加	14	28.6(4/14)			60.0(6/10)			75.0(3/4)
参加	228	45.2(103/228)			64.8(81/125)			40.8(42/103)
HIV相关变量
确诊HIV感染时间(年)			0.345	0.557		1.683	0.195		0.013	0.910
< 6	125	42.4(53/125)			69.4(50/72)			41.5(22/53)
≥6	117	46.2(54/117)			58.7(37/63)			42.6(23/54)
抗病毒治疗时间(年)			1.557	0.212		7.128	0.008		0.358	0.549
< 6	153	41.2(63/153)			72.2(65/90)			44.4(28/63)
≥6	89	49.4(44/89)			48.9(22/45)			38.6(17/44)
基线CD⁺4 T淋巴细胞计数(个/μl)			5.631	0.060		1.605	0.448		4.082	0.129
< 350	81	44.4(36/81)			64.4(29/45)			55.6(20/36)
350~	65	55.4(36/65)			55.2(16/29)			36.1(13/36)
≥500	96	36.5(35/96)			68.9(42/61)			34.3(12/35)
基线HIV病毒载(拷贝/ml)^b			10.012	0.002		0.801	0.371		0.258	0.611
< 200	173	49.7(86/173)			60.9(53/87)			37.2(32/86)
≥200	25	16.0(4/25)			71.4(15/21)			50.0(2/4)
注：^a由于对象拒绝回答，或部分数据未收集到，最终收集238份数据；^b由于对象拒绝回答，或部分数据未收集到，最终收集198份数据。

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表 2 不同基线高血压水平HIV感染者的治疗和控制情况

Table 2. Current treatment and control rates of hypertension among HIV-infected individuals according to blood pressure levels at baseline

变量	合计(n)	治疗率(治疗人数/总人数)[%(n/N)]	未治疗组高血压控制率(控制人数/未治疗人数)[%(n/N)]	χ²值	P值	治疗组高血压控制率(控制人数/治疗人数)[%(n/N)]	χ²值	P值
考虑基线高血压诊断史的基线血压水平				4.716	0.095		6.156	0.046
轻度高血压	91	11.0(10/91)	69.1(56/81)			10.0(1/10)
中度或重度高血压	30	13.3(4/30)	46.2(12/26)			75.0(3/4)
高血压临床诊断史	121	76.9(93/121)	67.9(19/28)			44.1(41/93)
基线调查血压水平				4.869	0.088		9.945	0.007
正常血压	47	74.5(35/47)	58.3(7/12)			62.9(22/35)
轻度高血压	140	32.9(46/140)	70.2(66/94)			28.3(13/46)
中度或重度高血压	55	47.3(26/55)	48.3(14/29)			38.5(10/26)

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表 3 HIV感染者治疗和未治疗者高血压控制率的影响因素

Table 3. Factors associated with control rate of hypertension among HIV-infected individuals

变量	未治疗者		治疗者
变量	aOR(95% CI)值	P值	aOR(95% CI)值	P值
年龄(岁)
< 45	1.000		1.000
≥45	0.724(0.317~1.655)	0.444	0.230(0.034~1.536)	0.129
性别
女	1.000		1.000
男	1.055(0.400~2.780)	0.914	1.191(0.386~3.680)	0.761
抗病毒治疗时间(年)
< 6	1.000		-
≥6	0.355(0.165~0.765)	0.008	-
高血压家族史
否	-		1.000
是	-		0.153(0.055~0.420)	< 0.001
腹部肥胖
无	-		1.000
有	-		0.555(0.221~1.393)	0.210
基线血压
正常血压	1.000		1.000
轻度高血压	1.423(0.390~5.192)	0.593	0.130(0.041~0.406)	0.001
中重度高血压	0.502(0.117~2.158)	0.354	0.263(0.075~0.915)	0.036

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参考文献(19)

[1]	Shah AS, Stelzle D, Lee KK, et al. Global burden of atherosclerotic cardiovascular disease in people living with HIV[J]. Circulation, 2018, 138(11):1100-1112. DOI: 10.1161/CIRCULATIONAHA.117.033369.
[2]	Lin H, Ding Y, Ning C, et al. Age-specific associations between HIV infection and carotid artery intima-media thickness in China:a cross-sectional evaluation of baseline data from the CHART cohort[J]. Lancet HIV, 2019, 6(12):860-868. DOI: 10.1016/S2352-3018(19)30263-2.
[3]	Armah KA, Chang CC, Baker JV, et al. Prehypertension, hypertension, and the risk of acute myocardial infarction in HIV-infected and -uninfected veterans[J]. Clin Infect Dis, 2014, 58(1):121-129. DOI: 10.1093/cid/cit652.
[4]	Batavia AS, Severe P, Lee MH, et al. Blood pressure and mortality in a prospective cohort of HIV-infected adults in Port-au-Prince, Haiti[J]. J Hypertens, 2018, 36(7):1533-1539. DOI: 10.1097/HJH.0000000000001723.
[5]	中国高血压防治指南修订委员.中国高血压防治指南[M].北京:人民卫生出版社, 2010:19. Writing Group of 2010 Chinese Guidelines for the Management of hypertension. 2010 Chinese guidelines for the management of hypertension[M]. Beijing:People's Medical Publishing House, 2010:19.
[6]	中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究[J].中华流行病学杂志, 2002, 23(1):5-10. DOI: 10.3760/j.issn:0254-6450.2002.01.003. Cooperartive Meta-analysis Group of China Obesity Task Force. Predictive value of body mass index and waist circumference to risk factors of related diseases in Chinese adult population[J]. Chin J Epidemiol, 2002, 23(1):5-10. DOI: 10.3760/j.issn:0254-6450.2002.01.003.
[7]	Weber R, Ruppik M, Rickenbach M, et al. Decreasing mortality and changing patterns of causes of death in the Swiss HIV Cohort Study[J]. HIV Med, 2013, 14(4):195-207. DOI: 10.1111/j.1468-1293.2012.01051.x.
[8]	Nakagawa F, Lodwick RK, Smith CJ, et al. Projected life expectancy of people with HIV according to timing of diagnosis[J]. AIDS, 2012, 26(3):335-343. DOI: 10.1097/QAD.0b013e32834dcec9.
[9]	Smith CJ, Ryom L, Weber R, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011(D:A:D):a multicohort collaboration[J]. Lancet, 2014, 384(9939):241-248. DOI: 10.1016/S0140-6736(14)60604-8.
[10]	胡美琴, 侯斌, 张晓宇, 等.西安市成年人高血压患病率、知晓率、治疗率和控制率现状[J].中国慢性病预防与控制, 2015, 23(2):104-108. DOI: 10.16386/j.cjpccd.issn.1004-6194.2015.02.017. Hu MQ, Hou B, Zhang XY, et al. Morbidity, awareness rate, treatment rate and control rate of hypertension among adults in Xi'an city[J]. Chin J Prev Contr Chron Dis, 2015, 23(2):104-108. DOI: 10.16386/j.cjpccd.issn.1004-6194.2015.02.017.
[11]	Wang Z, Chen Z, Zhang L, et al. Status of hypertension in China[J]. Circulation, 2018, 137(22):2344-2356. DOI: 10.1161/CIRCULATIONAHA.117.032380.
[12]	王良友, 刘令初, 周群玉, 等.浙江省台州市社区高血压患者血压控制影响因素分析[J].中国慢性病预防与控制, 2016, 24(9):678-680. DOI: 10.16386/j.cjpccd.issn.1004-6194.2016.09.010. Wang LY, Liu LC, Zhou QY, et al. Analysis of influencing factors of hypertension control in community hypertensive patients in Taizhou City, Zhejiang Province[J]. Chin J Prev and Contr Chron Dis, 2016, 24(9):678-680. DOI: 10.16386/j.cjpccd.issn.1004-6194.2016.09.010.
[13]	Manner IW, Baekken M, Oektedalen O, et al. Hypertension and antihypertensive treatment in HIV-infected individuals. A longitudinal cohort study[J]. Blood Press, 2012, 21(5):311-319. DOI: 10.3109/08037051.2012.680742.
[14]	中国疾病预防控制中心.中国慢性病及其危险因素监测报告(2010)[R].北京: 军事医学科学出版社, 2012: 10. Chinese Center for Disease Control and Prevention. Report of chronic disease risk factor surveillance in China[R]. Beijing: Military Science Publishing House, 2012: 10.
[15]	尤川梅, 熊先军, 吴月华, 等.社区高血压控制效果及其影响因素分析[J].中国卫生事业管理, 2010, 27(8):513-517. DOI: 10.3969/j.issn.1004-4663.2010.08.003. You CM, Xiong XJ, Wu YH, et al. Analyzing the effect of community-based hypertension prevention and control and its influencing factors[J]. Chin Health Service Manage, 2010, 27(8):513-517. DOI: 10.3969/j.issn.1004-4663.2010.08.003.
[16]	陈锦秀, 张文霞, 李壮苗.高血压家族史子代亲属的高血压知识、态度、行为的调查研究[J].福建中医药, 2007, 38(5):56-57. DOI: 10.13260/j.cnki.jfjtcm.009321. Chen JX, Zhang WX, Li ZM. A study on the knowledge, attitude and behavior of hypertension in offspring with family history of hypertension[J]. Fujian J Tradit Chin Med, 2007, 38(5):56-57. DOI: 10.13260/j.cnki.jfjtcm.009321.
[17]	Gelpi M, Afzal S, Lundgren J, et al. Higher risk of abdominal obesity, elevated low-density lipoprotein cholesterol, and hypertriglyceridemia, but not of hypertension, in people living with human immunodeficiency virus (HIV):results from the copenhagen comorbidity in HIV infection study[J]. Clin Infect Dis, 2018, 67(4):579-586. DOI: 10.1093/cid/ciy146.
[18]	冯润川. 218例艾滋病并高血压患者合理应用降压药物治疗效果分析[J].医学信息, 2011, 24(7):3198-3199. DOI: 10.3969/j.issn.1006-1959.2011.07.389. Feng RC. Analysis of the therapeutic effect of antihypertensive drugs on 218 AIDS patients with hypertension[J]. Medical Information, 2011, 24(7):3198-3199. DOI: 10.3969/j.issn.1006-1959.2011.07.389.
[19]	Cohen JB, Lotito MJ, Trivedi UK, et al. Cardiovascular events and mortality in white coat hypertension:a systematic review and meta-analysis[J]. Ann Intern Med, 2019, 170(12):853-862. DOI: 10.7326/M19-0223.

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变量	合计(n)	治疗率(治疗人数/总人数[%(n/N)]	χ²值	P值	未治疗组高血压控制率(控制人数/未治疗人数)[%(n/N)]	χ²值	P值	治疗组高血压控制率(控制人数/治疗人数)[%(n/N)]	χ²值	P值
年龄(岁)			27.587	< 0.001		0.582	0.446		0.163	0.687
< 45	51	11.8(6/51)			68.9(31/45)			50.0(3/6)
≥45	191	52.9(101/191)			62.2(56/90)			41.6(42/101)
性别			1.503	0.220		0.155	0.694		0.051	0.822
女	48	52.1(25/48)			60.9(14/23)			44.0(11/25)
男	194	42.3(82/194)			65.2(73/112)			41.5(34/82)
个人年收入(元)			0.812	0.666		0.664	0.717		0.530	0.767
< 10 000	63	39.7(25/63)			60.5(23/38)			36.0(9/25)
10 000~	85	47.1(40/85)			68.9(31/45)			45.0(18/40)
≥30 000	94	44.7(42/94)			63.5(33/52)			42.9(18 /42)
吸烟			1.744	0.187		1.978	0.160		0.774	0.379
否	161	47.2(76/161)			60.0(51/85)			44.7(34/76)
是	81	38.3(31/81)			72.0(36/50)			35.5(11/31)
饮酒			0.381	0.537		0.123	0.726		0.016	0.900
否	160	45.6(73/160)			65.5(57/87)			42.5(31/73)
是	82	41.5(34/82)			62.5(30/48)			41.2(14/34)
BMI(kg/m²)			1.012	0.315		0.237	0.627		0.994	0.319
< 24	151	41.7(63/151)			65.9(58/88)			46.0(29/63)
≥24	91	48.4(44/91)			61.7(29/47)			36.4(16/44)
腹部肥胖			3.023	0.082		0.750	0.388		2.981	0.084
无	126	61.1(77/126)			67.5(52/49)			51.0(25/77)
有	116	50.0(58/116)			60.3(35/58)			34.5(20/58)
饮食偏咸			1.085	0.581		0.561	0.755		3.360	0.186
清淡	54	48.2(26/54)			64.3(18/28)			53.9(14/26)
一般	75	46.7(35/75)			60.0(24/40)			45.7(16/35)
偏咸	113	40.7(46/113)			67.2(45/67)			32.6(15/46)
经常锻炼			3.007	0.083		0.072	0.788		0.024	0.877
否	146	39.7(58/146)			63.6(56/88)			41.4(24/58)
是	96	51.0(49/96)			66.0(31/47)			42.9(21/49)
糖尿病患病^a			2.517	0.113		1.740	0.187		1.555	0.212
否	211	43.1(91/211)			65.8(79/120)			39.6(36/91)
是	27	59.3(16/27)			45.5(5/11)			56.3(9/16)
高血脂			14.622	< 0.001		0.157	0.687		0.636	0.425
否	212	39.6(84/212)			64.1(82/128)			44.1(37/84)
是	30	76.7(23/30)			71.4(5/7)			34.8(8/23)
高血压家族史			7.228	0.007		1.271	0.260		11.432	< 0.001
否	123	35.8(44/123)			68.4(54/79)			61.4(27/44)
是	119	52.9(63/119)			58.9(33/56)			28.6(18/63)
医疗保险			1.474	0.225		0.093	0.762		1.860	0.173
不参加	14	28.6(4/14)			60.0(6/10)			75.0(3/4)
参加	228	45.2(103/228)			64.8(81/125)			40.8(42/103)
HIV相关变量
确诊HIV感染时间(年)			0.345	0.557		1.683	0.195		0.013	0.910
< 6	125	42.4(53/125)			69.4(50/72)			41.5(22/53)
≥6	117	46.2(54/117)			58.7(37/63)			42.6(23/54)
抗病毒治疗时间(年)			1.557	0.212		7.128	0.008		0.358	0.549
< 6	153	41.2(63/153)			72.2(65/90)			44.4(28/63)
≥6	89	49.4(44/89)			48.9(22/45)			38.6(17/44)
基线CD⁺4 T淋巴细胞计数(个/μl)			5.631	0.060		1.605	0.448		4.082	0.129
< 350	81	44.4(36/81)			64.4(29/45)			55.6(20/36)
350~	65	55.4(36/65)			55.2(16/29)			36.1(13/36)
≥500	96	36.5(35/96)			68.9(42/61)			34.3(12/35)
基线HIV病毒载(拷贝/ml)^b			10.012	0.002		0.801	0.371		0.258	0.611
< 200	173	49.7(86/173)			60.9(53/87)			37.2(32/86)
≥200	25	16.0(4/25)			71.4(15/21)			50.0(2/4)
注：^a由于对象拒绝回答，或部分数据未收集到，最终收集238份数据；^b由于对象拒绝回答，或部分数据未收集到，最终收集198份数据。

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台州市HIV感染者高血压治疗率与控制率现状

doi: 10.16462/j.cnki.zhjbkz.2020.07.008

通讯作者:
丁盈盈, E-mail:dingyy@fudan.edu.cn

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Hypertension treatment and control rates among HIV-infected individuals in Taizhou City

Corresponding author: DING Ying-ying, E-mail:dingyy@fudan.edu.cn

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留言板

台州市HIV感染者高血压治疗率与控制率现状

doi: 10.16462/j.cnki.zhjbkz.2020.07.008

通讯作者: 丁盈盈, E-mail:dingyy@fudan.edu.cn

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出版历程

Hypertension treatment and control rates among HIV-infected individuals in Taizhou City

Corresponding author: DING Ying-ying, E-mail:dingyy@fudan.edu.cn

计量

出版历程

目录

通讯作者:
丁盈盈, E-mail:dingyy@fudan.edu.cn