河南省农村地区二线抗病毒治疗艾滋病患者生存质量及影响因素分析

Analysis of Quality of Life and Influencing Factors of AIDS Patients from a Rural Area of Henan Province Treated with Second-line Antiviral Therapy

目的探讨河南省农村地区二线抗病毒治疗艾滋病患者的生存质量状况,分析其影响因素。方法2019年1-10月,在河南省某三市(县)艾滋病高发区,采用便利抽样办法,使用中文版WHOQOL-HIV-BREF量表,调查二线抗病毒治疗艾滋病患者生存质量并分析影响因素。结果共有176例艾滋病患者纳入分析,男95例,女81例,单因素方差分析结果显示,男性在独立性领域得分[(12.22±1.68)分]高于女性([11.62±1.80)分],差异有统计学意义(P<0.05)。受教育时间长者生理领域得分[(13.10±1.84)分]、环境领域得分[(11.43±2.02)分]高于受教育时间短者;有配偶者在心理领域、环境领域得分、生存质量总分分别为(12.07±2.03)分、(12.22±2.17)分、(73.93±7.51)分,高于无配偶者;病毒载量较低者心理领域得分及生存质量总评分分别为(11.90±2.01)分、(73.38±7.32)分,高于病毒载量较高者;CD4^(+)T淋巴细胞计数高者在多领域得分高于CD4^(+)T细胞计数低者;经有偿献血感染HIV的患者在独立性及环境领域得分及生存质量总分高于经其他途径感染者。多元线性回归分析结果显示,心理领域、社会关系领域得分与CD4^(+)T细胞计数、病程相关;生理领域、环境领域和精神领域得分与受教育时间明显相关;独立性领域得分与性别相关;生存质量总得分与病毒载量、CD4^(+)T细胞计数、病程均具有相关性;差异均有统计学意义(P<0.05)。结论河南省农村地区二线抗病毒治疗艾滋病患者的生存质量主要受性别、受教育时间、病毒载量、CD4^(+)T细胞计数、病程等多种因素的影响。针对影响因素积极早期干预,特别是加强基础疾病治疗,提高CD4^(+)T细胞计数,同时加强疾病健康教育,提高患者依从性,将有助于提高患者的生存质量。

Objective To investigate the quality of life of AIDS patients from a rural area of Henan Province treated with second-line antiviral therapy and analyze the influencing factors.Methods The quality of life of AIDS patients from three cities(counties)of Henan Province treated with second-line antiviral therapy was investigated from January to October 2019.The influencing factors were analyzed using the Chinese version of WHOQOL-HIV-BREF scale and convenience sampling method.Results A total of 176 AIDS patients were included in the analysis,95 males and 81 females.One-way analysis of variance showed that male scores in the independence level(12.22±1.68)were higher than female scores(11.62±1.80),and the difference was statistically significant(P<0.05).The physiological field and environmental field scores in the elderly with a long education time(13.10±1.84)were higher than those with a short education time(11.43±2.02).The scores of psychological field(12.07±2.03),environmental field(12.22±2.17)and quality of life(73.93±7.51)of couples were higher than those of non-spouses(11.27±1.79),(11.58±1.70)and(71.01±6.65),respectively.The scores of psychological field and quality of life in patients with low viral load were(11.90±2.01)and(73.38±7.32),respectively.Patients infected with HIV through paid blood donation had higher scores in independence,environment and quality of life than those infected by other means.Multiple linear regression analysis showed that the psychological field and social relationship field scores were correlated with CD4^(+)T cell count and disease course.The scores in the physiological field,environmental field and spiritual field were significantly related to time of education.The scores in the field of independence were correlated with gender.The total quality of life score was correlated with viral load,CD4^(+)T cell count and disease course.The differences were statistically significant(P<0.05).Conclusion The quality of life of AIDS patients in rural areas of Henan province treated with second-line antiviral therapy is mainly affected by gender,education time,viral load,CD4^(+)T cell count and disease course.Early intervention based on the influencing factors,especially strengthening the treatment of basic diseases,improving CD4^(+)T cell count,strengthening health education and improving patient compliance,will help improve the quality of life of AIDS patients.