内江市HIV/AIDS抗病毒治疗效果影响因素分析

Influencing Factors in Efficacy of Antiviral Treatment of HIV/AIDS in Neijiang

目的探讨HIV感染者及艾滋病患者抗病毒治疗效果的影响因素。方法选择中国疾病预防控制信息系统中录入在案的内江市2011-2015年首次进行抗病毒治疗的315例HIV/AIDS患者作为研究对象,收集一般人口学特征信息、治疗方案、漏服情况、临床分期、基线及治疗不同时间后的CD4+T淋巴细胞(简称CD4细胞)计数水平,使用Excel 2003建立数据库,根据治疗1年后CD4细胞计数是否升高>100 cells/μl分为升高组与非升高组,采用探索性病例对照研究记录相关信息,采用SPSS 21.0统计软件对可能影响CD4细胞计数升高的因素进行卡方分析、Logistic回归分析。结果 315例研究对象中有289例随访满12个月,157例治疗12个月后CD4细胞计数升高>100 cells/μl,基线CD4细胞计数、临床分期、漏服情况与抗病毒治疗后CD4细胞计数升高有相关性,差异有统计学意义(P<0.01);多因素Logistic回归分析显示,临床Ⅲ期、漏服是危险因素,基线CD4<200 cells/μl是保护因素(P<0.05)。结论基线CD4细胞计数、临床分期、漏服情况是影响HIV/AIDS患者抗病毒治疗后CD4淋巴细胞计数升高程度的相关因素,在临床实践中应加强重视,科学有效地发挥抗病毒治疗的效果。

Objective To explore the influencing factors of antiviral therapy for HIV infected patients and AIDS patients. Methods 315 cases of HIV/AIDS were selected from China disease prevention and control information system which were inputted during 2011 -2015 of Neijiang city for the first time of antiviral therapy as the research objects, and collected the information of demographic characteristics, treatment, missed, clinical stage, treatment at baseline and different time after CD4- positive T - lymphocyte （ CD4 cell） counts, used Excel 2003 database, according to the 1 years after treatment, CD4 cell count increased, 100 cells/ L was divided into group and non - elevated group, used exploratory case control study and recorded the relevant information, and used SPSS 21.0 statistical software to analyze the factors that might affect the increase of CD4 cell count, chi square analysis, logistic regression analysis. Results Total 315 subjects, 289 cases were followed up for 12 months, and 157 cases after 12 months of treatment, CD4 cell count 〉 100 cells/L, baseline CD4 cell count, clinical stage, and missed antiviral therapy after CD4 cell count increased correlation, the difference was statistically significant （P 〈 0. 001 ） ; multi factor Logistic regression analysis showed that clinical stage Ⅲ, missed were the risk factors, baseline CD4 〈 200 ceils/L is a protective factor （P 〈 0. 05 ）. Conclusion Baseline CD4 -positive T- lymphocyte count, clinical stage, missed are the related factors to effect the increasing of CD4 ＋ T lymphocyte with HIV/AIDS patients after antiviral treatment. Should be focus on clinical practice, for it＇s scientifically and effectively effect in antiretroviral therapy.