四川省艾滋病抗病毒治疗患者生存时间分析

Survival analysis for AIDS patients in Sichuan province after antiretroviral therapy

目的了解四川省艾滋病抗病毒治疗人群基本特征及抗病毒治疗后生存时间。方法利用国家DataFax抗病毒治疗信息收集系统中四川省治疗数据信息,使用SPSS 13.0进行相关分析。结果本研究纳入766例患者,基线CD4+T≤200个/mm3时开始抗病毒治疗的患者占68.6%(526/766);截止到2009年9月30日,共有114例研究对象死亡,其中82.5%(94/114)死于艾滋病相关疾病,死于意外、自杀和其他原因的分别有4、3、12例;患者抗病毒治疗后1年的生存率为90%,2年生存率为85%,3年生存率为82%;含AZT方案/d4T方案患者生存率差异无统计学意义;艾滋病相关疾病死亡的94例中,有82例开始抗病毒治疗时CD4+T淋巴细胞计数≤200个/mm3,占87.2%,CD4+T淋巴细胞计数>200个/mm3时开始治疗的患者占12.8%(12/94)。开始治疗时不同CD4+T淋巴细胞计数患者的生存期差异有统计学意义(χ2=15.682,P<0.01)。结论四川省抗病毒治疗患者的生存率变化趋势与全国水平基本一致,根据WHO最新修订的艾滋病抗病毒治疗纳入标准,需要提前感染者开始抗病毒治疗的时间。

Objective To know the basic characteristics and survival time of AIDS patients in Sichuan province after antiretroviral therapy for the improvement of the therapy.Methods The information on antiretroviral therapy were collected by the DataFax Antiretroviral Therapy Information System in China and analyzed with SPSS13.0.Results Totally 766 patients were selected.There were 68.6%（526/766） of the patients starting the therapy at the baseline of CD4＋T lymphocyte count less than 200/mm3.The patients had the survival rate of 90%,85%,and 82% after one,two,and three years of the treatment,respectively.The results of log-rank test showed that there was no significant difference in the survival rate between the patients with AZT treatment and d4T treatment（χ2=1.972,P=0.160）.There was a significant correlation between the baseline of CD4＋T lymphocyte count and the survival rate（χ2=15.682,P0.000 1）.Conclusion The survival rate after antiretroviral treatment was consistent with the national level.According to the latest revision of WHO＇s inclusion criteria,the antiretroviral therapy should be started earlier.