泸州市2010―2019年HIV/AIDS患者生存时间及影响因素分析

吴杨昊天; 冯才碧; 陈航; 郭曼; 杨娜; 刘倩倩; 闫欢; 丁明峰; 李改云; 李懿伦; 韩雪梅; 曹永文

doi:10.16462/j.cnki.zhjbkz.2021.12.010

泸州市2010―2019年HIV/AIDS患者生存时间及影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2021.12.010

1.
730000 兰州，兰州大学公共卫生学院
2.
646000 泸州，泸州市疾病预防控制中心性病艾滋病防制科
3.
646000 泸州，西南医科大学附属医院内分泌科
4.
730050 兰州，甘肃省妇幼保健院

基金项目:

甘肃省卫生行业科研计划 GSWSKY2017-43

详细信息

通讯作者:
冯才碧，E-mail: 794638738@qq.com

韩雪梅，E-mail: xmhan@lzu.edu.cn

中图分类号: R512.91;R181.3
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- 被引次数: 0
出版历程
- 收稿日期: 2021-03-18
- 修回日期: 2021-06-09
- 网络出版日期: 2021-12-27
- 刊出日期: 2021-12-10

Analysis of survival and its related factors of HIV/AIDS patient in Luzhou, 2010-2019

1.
School of Public Health, Lanzhou University, Lanzhou 730000, China
2.
Department of STD/AIDS Control and Prevention, Luzhou Center for Disease Control and Prevention, Luzhou 646000, China
3.
Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
4.
Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730050, China

Funds:

Health Industry Research Program of Gansu Province GSWSKY2017-43

More Information

Corresponding author: FENG Cai-bi, E-mail: 794638738@qq.com; HAN Xue-mei, E-mail: xmhan@lzu.edu.cn

摘要

摘要: 目的分析四川省泸州市HIV/AIDS患者生存情况及其影响因素。方法选取2010―2019年泸州市报告的≥15岁HIV/AIDS患者, 采用寿命表法计算生存率，采用Kaplan-Meier法计算中位生存时间和绘制生存曲线，采用Cox比例风险回归模型分析生存时间的影响因素。结果共纳入研究对象12 274例，中位生存时间为87.35(95% CI: 86.22~88.49)个月，确诊后1、3、5、7和9年累积生存率分别为78%、73%、69%、66%和63%；多因素分析结果显示，在发生AIDS相关死亡风险方面，男性是女性的1.491倍；汉族是其他民族的2.118倍；离异或丧偶是已婚的1.545倍；确诊感染时的年龄≥60岁是15~＜20岁的3.392倍；大专及以上是文盲的0.473倍；注射毒品、采(供)血及输血/血液制品是异性性传播的1.513倍；样本来源于医疗机构是检测咨询的1.131倍；首次检测CD4⁺T淋巴细胞计数为≥501个/μl是≤200个/μl的0.205倍；首次诊断疾病状态为AIDS是HIV感染的1.166倍；未接受抗病毒治疗是接受抗病毒治疗的3.524倍。结论性别、婚姻状况、诊断时的年龄、文化程度、感染途径、样本来源、首次检测CD4⁺T淋巴细胞计数、疾病状态及抗病毒治疗是影响HIV/AIDS患者生存时间的因素，早发现、早诊断、早治疗可降低HIV/AIDS患者的死亡风险。
- HIV/AIDS患者 /
- 生存时间 /
- 影响因素
Abstract: Objective To analyze the survival of HIV/AIDS patient and its related factors in Luzhou City. Methods The HIV/AIDS patient aged 15 years and above in Luzhou City from 2010 to 2019 were selected. Life table method was used to calculate the survival rate. Kaplan-Meier method was used to calculate the average survival time and draw the survival curve. Cox proportion hazard regression model was performed to identify the factors related to survival time. Results A total number of 12 274 cases were selected, the median survival time was 87.35 (86.22-88.49) months. The survival rate of 1, 3, 5, 7 and 9 years were 78%, 73%, 69%, 66%, and 63% respectively. Cox multivariate analysis showed that the risk of death in men was 1.491 times that than in women. The Han had 2.118 the risk times than other ethnic groups. The divorced or widowed had 1.545 times the risk than the married. The aged 60 years and above at the time of infection had 3.392 times risk than the aged less than or equal to 15- < 21 years old. The college and above had 0.473 the risk times than the illiteracy. Injecting drugs, collecting (supplying) blood and blood/blood products transfusions were 1.513 times than heterosexual transmission. The samples obtained from medical institutions were 1.131 times than detection of consulting. The first CD4⁺T cell test value of 501- cells/μl was 0.205 times than ≤200 cells/μl. First diagnosed AIDS was 1.166 times than HIV infection. Not receiving antiviral treatment was 3.524 times than receiving antiviral treatment. Conclusions The factors such as gender, marital status, age, education level, transmission route, sample source, first CD4⁺T cell count, disease state and antiviral treatment affect the survival of HIV/AIDSpatient. Early detection, early diagnosis, and early treatment can reduce the risk of death from HIV/AIDS cases.
- HIV/AIDS patient /
- Survival analysis /
- Influencing factors

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图 1 不同治疗情况的HIV/AIDS患者生存曲线

Figure 1. Survival curves of HIV/AIDS cases with different treatment situations

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图 2 不同治疗情况的HIV感染者生存曲线

Figure 2. Survival curves of HIV infectors with different treatment situations

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图 3 不同治疗情况的AIDS患者生存曲线

Figure 3. Survival curves of AIDS patients with different treatment situations

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表 1 2010―2019年泸州市HIV/AIDS患者生存状况

Table 1. Survival situation of HIV/AIDS cases in Luzhou from 2010 to 2019

观察时间(月)	期初观察人数	删失人数	有效观察人数	死亡人数	死亡率	生存率	累积生存率	累积生存率标准误
0	12 274	3 070	10 739.0	1 800	0.17	0.83	0.83	0.00
12	7 404	2 107	6 350.5	375	0.06	0.94	0.78	0.00
24	4 922	1 221	4 311.5	147	0.03	0.97	0.76	0.00
36	3 554	953	3 077.5	113	0.04	0.96	0.73	0.01
48	2 488	768	2 104.0	59	0.03	0.97	0.71	0.01
60	1 661	498	1 412.0	39	0.03	0.97	0.69	0.01
72	1 124	433	907.5	21	0.02	0.98	0.67	0.01
84	670	263	538.5	12	0.02	0.98	0.66	0.01
96	395	207	291.5	6	0.02	0.98	0.64	0.01
≥108	182	180	92.0	2	0.02	0.98	0.63	0.01

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表 2 2010―2019年泸州市HIV/AIDS患者生存时间相关因素的Cox比例风险模型分析

Table 2. Cox proportional hazard regression model analyses with the HIV/AIDS cases in Luzhou from 2010 to 2019

变量	HIV/AIDS患者数(n=12 274)	死亡例数[n(%)]	单因素分析		多因素分析
变量	HIV/AIDS患者数(n=12 274)	死亡例数[n(%)]	HR(95% CI)值	P值	HR(95% CI)值	P值
性别
女	3 305(26.93)	455(17.68)	1.000		1.000
男	8 969(73.07)	2 119(82.32)	1.844(1.667~2.041)	＜0.001	1.491(1.342~1.656)	＜0.001
民族
其他	111(0.90)	9(0.35)	1.000		1.000
汉	12 163(99.10)	2 565(99.65)	2.632(1.368~5.065)	0.004	2.118(1.099~4.082)	0.025
婚姻状况
已婚	5 627(45.84)	963(37.41)	1.000		1.000
未婚	2 237(18.23)	431(16.74)	1.018(0.909~1.141)	0.753	1.605(1.416~1.820)	＜0.001
离异或丧偶	4 229(34.45)	1 169(45.42)	1.620(1.488~1.764)	＜0.001	1.545(1.415~1.687)	＜0.001
不详	181(1.47)	11(0.43)	0.227(0.125~0.411)	＜0.001	0.223(0.122~0.405)	＜0.001
确诊感染时的年龄组(岁)
15~＜21	280(2.28)	21(0.82)	1.000		1.000
21~＜41	2 708(22.06)	348(13.52)	1.877(1.208~2.916)	0.005	1.382(0.864~2.211)	0.177
41~＜60	4 662(37.98)	874(33.95)	3.476(2.254~5.359)	＜0.001	2.181(1.358~3.502)	0.001
≥60	4 624(37.67)	1 331(51.71)	6.702(4.351~10.323)	＜0.001	3.392(2.100~5.478)	＜0.001
职业
农民及民工	8 236(67.10)	1 915(74.40)	1.000		1.000
家政、家务及待业	2 199(17.92)	379(14.72)	0.625(0.559~0.698)	＜0.001	0.863(0.769~0.968)	0.012
离退人员	280(2.28)	90(3.50)	1.351(1.094~1.669)	0.005	0.997(0.799~1.244)	0.980
工人	312(2.54)	50(1.94)	0.557(0.420~0.738)	＜0.001	0.808(0.608~1.075)	0.143
商业服务	399(3.25)	38(1.48)	0.311(0.226~0.429)	＜0.001	0.859(0.617~1.196)	0.367
干部职员	73(0.59)	6(0.23)	0.248(0.111~0.552)	0.001	0.720(0.319~1.628)	0.430
学生	108(0.88)	4(0.16)	0.114(0.043~0.305)	＜0.001	0.486(0.171~1.387)	0.178
其他及不详	667(5.43)	92(3.57)	0.427(0.346~0.527)	＜0.001	0.613(0.493~0.763)	＜0.001
文化程度^a
文盲	1 699(13.84)	520(20.20)	1.000		1.000
小学	5 680(46.28)	1 276(49.57)	0.661(0.597~0.732)	＜0.001	0.846(0.761~0.941)	0.002
中学	4 208(34.28)	732(28.44)	0.409(0.365~0.458)	＜0.001	0.740(0.648~0.846)	＜0.001
大专及以上	656(5.34)	46(1.79)	0.149(0.110~0.201)	＜0.001	0.473(0.340~0.657)	＜0.001
感染途径
异性性传播	11 064(90.14)	2 476(96.19)	1.000		1.000
同性性传播	805(6.56)	66(2.56)	0.284(0.222~0.363)	＜0.001	0.656(0.504~0.853)	0.002
注射毒品、采(供)血及输血/血液制品	100(0.81)	29(1.13)	0.959(0.665~1.383)	0.822	1.513(1.009~2.270)	0.045
其他及不详	305(2.48)	3(0.12)	0.031(0.010~0.096)	＜0.001	0.020(0.006~0.061)	＜0.001
样本来源
检测咨询	1 868(15.22)	307(11.93)	1.000		1.000
医疗机构	8 681(70.73)	2 029(78.83)	1.703(1.510~1.920)	＜0.001	1.131(1.001~1.278)	0.049
羁押场所	196(1.60)	34(1.32)	1.028(0.722~1.465)	0.878	0.665(0.451~0.981)	0.040
其他	1 529(12.46)	204(7.92)	1.277(1.069~1.527)	0.007	0.886(0.739~1.063)	0.192
首次检测CD4⁺T淋巴细胞计数(个/μl)
≤200	2 167(17.66)	811(31.51)	1.000		1.000
201~350	2 869(23.37)	299(11.62)	0.240(0.210~0.274)	＜0.001	0.309(0.265~0.360)	＜0.001
351~500	2 335(19.02)	177(6.88)	0.165(0.140~0.194)	＜0.001	0.242(0.200~0.293)	＜0.001
≥501	2 440(19.88)	143(5.55)	0.117(0.098~0.140)	＜0.001	0.205(0.166~0.254)	＜0.001
未检测	2 463(20.07)	1 144(44.44)	1.252(1.143~1.371)	＜0.001	0.870(0.731~1.036)	0.118
首次诊断疾病状态
HIV	7 665(62.45)	1 490(57.89)	1.000		1.000
AIDS	4 609(37.55)	1 084(42.11)	1.210(1.119~1.309)	＜0.001	1.166(1.015~1.339)	0.030
抗病毒治疗
是	9 371(76.35)	1 156(44.91)	1.000		1.000
否	2 903(23.65)	1 418(55.09)	4.561(4.219~4.931)	＜0.001	3.524(3.107~3.997)	＜0.001
注：^a HIV/AIDS患者数有部分缺失。

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泸州市2010―2019年HIV/AIDS患者生存时间及影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2021.12.010

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冯才碧，E-mail: 794638738@qq.com

韩雪梅，E-mail: xmhan@lzu.edu.cn

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Analysis of survival and its related factors of HIV/AIDS patient in Luzhou, 2010-2019

Corresponding author: FENG Cai-bi, E-mail: 794638738@qq.com; HAN Xue-mei, E-mail: xmhan@lzu.edu.cn

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泸州市2010―2019年HIV/AIDS患者生存时间及影响因素分析

doi: 10.16462/j.cnki.zhjbkz.2021.12.010

通讯作者: 冯才碧，E-mail: 794638738@qq.com 韩雪梅，E-mail: xmhan@lzu.edu.cn

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Analysis of survival and its related factors of HIV/AIDS patient in Luzhou, 2010-2019

Corresponding author: FENG Cai-bi, E-mail: 794638738@qq.com; HAN Xue-mei, E-mail: xmhan@lzu.edu.cn

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通讯作者:
冯才碧，E-mail: 794638738@qq.com

韩雪梅，E-mail: xmhan@lzu.edu.cn