上海市某医院艾滋病合并梅毒病例特征分析及影响因素探讨

Characteristics and influencing factors of AIDS patients combined with syphilis in a hospital in Shanghai

为了解近年来上海市艾滋病合并梅毒患者的特征及变化趋势,探讨艾滋病患者合并梅毒的影响因素,本研究收集了2013—2019年上海市(复旦大学附属)公共卫生临床中心(简称临床中心)诊断为艾滋病合并梅毒的病例作为研究对象。经详细查询研究对象的住院登记资料和病史,本文整理出用于研究的资料,并将研究对象分为艾滋病合并梅毒组和艾滋病不合并梅毒组。结果显示,临床中心艾滋病患者中有10.55%合并梅毒;2013—2019年临床中心艾滋病合并梅毒感染率总体呈上升趋势(χ^(2)=17.640,P<0.05),每年7—8月份为收治高峰期。患者主要来源于本地居民(占55.49%),男女性别比为14∶1,平均年龄为38±12岁。通过Logistic回归分析发现,影响艾滋病合并梅毒的因素有性别、年龄、病例来源和CD4+T细胞计数,其中本地来源、年龄在21~40岁、男性和CD4+T细胞计数≤500/μL是艾滋病患者合并梅毒感染的高危因素。研究提示,上海市艾滋病合并梅毒感染病例数呈上升趋势,重点防控人群是上海市青壮年男性居民,应提高对此类人群的主动监测能力,加大筛查力度,做好健康教育;重点防控时间是每年7、8月份,应精准防控以期取得明显效果。本研究为上海市此类疾病防控提供了一定的科学依据。

The purpose of the current study is to understand the characteristics of AIDS patients combined with syphilis in Shanghai in recent years,explore the influencing factors of AIDS patients with syphilis,and provide a scientific basis for the prevention and control of such diseases in Shanghai.Through the collection of relevant data on the diagnosis of AIDS combined with syphilis cases discharged from the Shanghai Public Health Clinical Center during 2013 to 2019,the case characteristics and trend of changes were analyzed,and the relevant factors affecting AIDS patients with syphilis were studied.The results showed that the prevalence rate of syphilis among AIDS patients in Shanghai was 10.55%,The overall infection rate of AIDS complicated with syphilis in this hospital showed an upward trend from 2013 to 2019(χ^(2)=17.640,P<0.05).July-August is the peak period of annual admissions.The patients were mainly from local residents(55.49%),the male to female ratio was 14∶1,and the average age was(38±12)years old.Through logistic regression analysis,it was found that the factors affecting AIDS and syphilis were gender,age,source of cases,and CD4+T lymphocyte count.Among them,local,21-40 years old,male and CD4+T lymphocyte count≤500/μL are high risk factors for AIDS patients with syphilis infection.This study suggests that the number of AIDS-combined syphilis infection cases in Shanghai from 2013 to 2019 is on the rise.The key population for prevention and control is Shanghai’s young and middle-aged male residents.The ability to actively monitor such populations should be improved,and screening efforts should be increased as well as good health education.The key prevention and control period is July and August each year,and precise prevention and control are expected to achieve obvious results.