昆明地区不同抗病毒治疗方案艾滋病患者生存质量横断面调查

A Cross-sectional Survey on Quality of Life of AIDS Patients with Different Antiretroviral Regimens in Kunming Area

目的探讨昆明地区不同抗病毒治疗方案艾滋病患者生存质量状况。方法2021年12至2022年3月,在昆明市第三人民医院,采用问卷调查方式,使用中文版WHOQOL-HIV-BREF量表,调查服用不同抗病毒治疗方案艾滋病患者生存质量情况,多元线性回归分析将用于分析患者生存质量总分的影响因素。结果共有1243例艾滋病患者纳入分析,男798例,女445例,生存质量总分为均数±标准差。单因素方差分析结果显示,男性(67.67±9.86)分、汉族(67.22±9.74)分、高学历(69.12±10.07)分、居住地城市(67.66±9.74)分、3个月内无饮酒(67.52±10.01)分、30岁以下人群生存质量(68.15±10.58)分,总分高于相对应的女性(66.53±9.45)分、少数民族(66.57±9.60)分、低学历(64.43±8.51)分、农村(65.97±9.56)分、3个月内有饮酒(65.81±7.76)分、30岁以上人群(64.25±6.77)分,差异有统计学意义(P<0.05)。未婚者生存质量高于已婚、离异/丧偶者;高CD4水平(CD4≥500)者生存质量总分高于CD4水平较低的患者;MSM人群的生存质量得分高于异性传播及吸毒人群,以上因素差异均有统计学意义(P<0.05)。服用抗病毒治疗方案含整合酶抑制剂患者生存质量得分高于服用抗病毒治疗方案含非核苷类似物、蛋白酶抑制剂,差异具有统计学意义(P<0.05)。多元线性回归分析结果显示,饮酒、学历、感染途径、服药类型与生存质量总分存在相关性,其中有饮酒习惯(β=-1.670)与生存质量总分呈负相关;男男同性传播(β=4.790);大学以上学历(β=2.320);服用含整合酶抑制剂如含DTG方案的患者(β=7.014)、FTC/TAF/EVG/c(β=8.765)、BIC/FTC/TAF(β=13.141)为正相关,差异均有统计学意义(P<0.05)。结论昆明地区不同抗病毒治疗方案对艾滋病患者生存质量的影响主要包括服用抗病毒药物的类型、饮酒、学历等多种因素。

Objective To investigate the quality of life of AIDS patients on different antiretroviral regimens in Kunming.Methods From December 2021 to March 2022,questionnaire survey and Chinese version of WHOQOL-HIV-BREF scale were used in Kunming Third People’s Hospital to investigate the quality of life of AIDS patients taking different antiviral treatment regimes.Multiple linear regression analysis was used to analyze the factors influencing the total score of patients’quality of life.The total score of quality of life is shown in mean±standard deviation.Results The results of one-way ANOVA showed that,total score for quality of life in male(67.67±9.86),Han(67.22±9.74),education level(69.12±10.07),city of residence(67.66±9.74),no drinking within 3 months(67.52±10.01),under 30 years old(68.15±10.58)were higher than that of female(66.53±9.45),ethnic minorities(66.57±9.60),low education(64.43±8.51),rural(65.97±9.56),drinking within 3 months(65.81±7.76),over 30 years old(64.25±6.77),the difference was statistically significant(P<0.05).The quality of life was higher in the unmarried than in the married and divorced/widowed.The total quality of life score of patients with high CD4 level(CD4≥500)was higher than that of patients with low CD4 level.The quality of life score of MSM population was higher than that of heterosexual and drug abuse population,and the differences of the above factors were statistically significant(P<0.05).Quality of life scores of patients taking antiviral medication containing integrase inhibitors were higher than those taking antiviral therapy containing nonnucleoside analogues and protease inhibitors,and the difference was statistically significant(P<0.05).Multiple linear regression analysis showed that alcohol consumption,education,route of infection,and type of medication were correlated with the total quality of life score.Drinking habit(β=-1.670)was negatively correlated with the total score of quality of life;MSM transmission(β=4.790);university degree or above(β=2.320);patients taking integrase inhibitors such as DTG regimen(β=7.014),FTC/TAF/EVG/c(β=8.765),BIC/FTC/TAF(β=13.141)were positively correlated,and the differences were statistically significant(P<0.05).Conclusion The quality of life of AIDS patients with different antiretroviral treatment regimens in Kunming is mainly influenced by various factors such as the type of antiretroviral drugs taken,alcohol consumption,and education.