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

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

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.

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,6th months and 12th 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＆#39; s characteristics to get good outcome.