钦州市HIV/AIDS死亡情况及其影响因素研究

Studying on The Status of Mortality of HIV/AIDS Patients in Qinzhou City and Its Influencing Factors

目的:分析钦州市HIV/AIDS的死亡情况及其影响因素,为科学防控艾滋病提供依据。方法:采用回顾性队列研究方法,选取钦州市1997～2017年报告的13983例HIV/AIDS作为研究对象,通过中国疾病预防控制信息系统收集其相关资料,运用SPSS 21. 0对资料进行统计分析,采用Kaplan-Meier法描绘病例生存曲线并估计其累积病死率,采用Cox回归模型对研究对象生存时间的影响因素进行单因素和多因素分析。结果:13983例病例平均年龄(41. 62±16. 015)岁,男女比例3. 285∶1,已婚有配偶占53. 90%;感染途径以异性性传播为主,占70. 35%;接受抗病毒治疗者占50. 15%;肺部感染、HIV脑病和多发性恶性肿瘤是HIV/AIDS的3大主要死因,分别占38. 89%、20. 71%和17. 08%;截止随访时死亡病例占35. 71%,总死亡率为9. 96/100人年,艾滋病相关死亡密度为9. 48/100人年,进入队列后第1年、4年、7年、10年、13年、16年和19年的累积病死率分别为16. 4%、32. 6%、40. 2%、46. 9%、52. 7%、55. 5%和55. 5%。Cox回归单因素和多因素分析结果显示,性别、感染途径、职业、文化程度、发病年龄、病程阶段、CD4+T细胞计数和是否接受抗病毒治疗等8个因素均是病例死亡的影响因素。结论:钦州市艾滋病病死率较高,影响因素较多,应综合各种影响因素制订防治措施,以降低患者死亡率,提高其生活质量。

Objective To analyze the status of fatality of HIV/AIDS patients in Qinzhou City and its influencing factors,and provide references for HIV/AIDS prevention and control.Method 13983 cases of registered HIV/AIDS patients in Qinzhou City from 1997 to 2017 were sampled and analyzed with retrospective cohort study.Data was analyzed with software of SPSS 21.0,Kaplan-Meier method and COX regression proportional hazard model.Results The average age of 13983 cases was 41.62±16.015,whose sex ratio was 3.285∶1.53.90%of them had married and had a spouse.Most of them were infected by heterosexual sexual transmission(70.35%).50.15%of them received antiretroviral treatment.The top three deadly diseases of HIV/AIDS patients were pulmonary infection,HIV encephalopathy and multiple malignant tumors,accounting for 38.89%,20.71%and 17.08%,respectively.The fatality rate was 35.71%at the end of the follow-up,the annual mortality rate of which was 9.96%,and the mortality density was 9.48%.The mortality rate of these patients were 16.4%,32.4%,40.2%,46.9,52.7%,55.5%and55.5%in the 1 st,4 th,7 th,10 th,13 th,16 th and 19 th year after diagnosed,respectively.Univariate and multivariate analysis of COX regression proportional hazard model showed that factors of gender,infection route,occupation,education background,age,disease course,baseline CD4+T lymphocyte counts and whether receiving antiviral therapy could mainly influence its mortality.Conclusion The mortality rate of HIV/AIDS patients in Qinzhou City was relatively high,which influenced by many factors.It is suggested to implement comprehensive prevention and control measures to reduce the mortality rate and improve their life quality.