青海省西宁市HIV/AIDS人群抗病毒治疗前后CD4^(+)T淋巴细胞水平分析

Surveillance analysis of CD4^(+)T lymphocyte levels among HIV/AIDS population before and after antiviral treatment in Xining City,Qinghai Province

【目的】分析青海省西宁市人类免疫缺陷病毒感染者/艾滋病患者(简称“HIV/AIDS”)接受高效抗逆转录病毒治疗(HAART)前后CD4^(+)T淋巴细胞(简称“CD4细胞”)变化水平及其相关影响因素,为制定相应随访干预策略提供科学依据。【方法】于2023年2—7月,采用方便抽样法选取青海省西宁市接受HAART的468名HIV/AIDS人群进行问卷调查,并采集静脉血,使用流式细胞仪进行CD4细胞检测。采用SPSS 22.0软件进行t检验、方差分析及χ^(2)检验,并运用多元线性回归分析探索HIV/AIDS人群接受HAART后CD4细胞水平及其相关影响因素。【结果】单因素分析结果显示,不同年龄、民族、居住形式及年收入人群基线CD4细胞差异有统计学意义(P<0.05)。不同民族、婚姻状况、经常性体育锻炼、高血压患病、基线CD4细胞计数、HIV诊断年限、HAART治疗年限及治疗方案最近一次CD4细胞水平差异有统计学意义(P<0.05)。多元线性回归分析显示,基线CD4细胞计数在350~个·μL^(-1)(t=7.40)及≥500个·μL^(-1)(t=6.69)、HAART治疗年限在5~年(t=3.59)及≥10年(t=4.54)、HIV诊断年限≥10年(t=-2.58)、接受二线治疗方案人群(t=-2.49)与接受HAART后的最近一次CD4细胞水平之间存在统计学关联(P<0.05)。【结论】青海省西宁市HIV/AIDS人群的CD4细胞水平受多种因素影响,应对该人群开展全面健康干预,强化早发现早治疗策略的执行,定期监测相关生理、生化指标并进行健康宣教,促使该人群选择有益于健康的生活方式,从而多维度提升该人群的生活质量。

[Objective]To analyze the changes in CD4^(+)T lymphocyte(CD4 cells)levels and influencing factors in patients with human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS)before and after highly active anti-retroviral therapy(HAART)in Xining City,Qinghai Province,so as to provide a scientific basis for formulating corresponding follow-up intervention strategies.[Methods]From February to July,2023,468 HIV/AIDS patients who received HAART in Xining,Qinghai Province were selected using a convenient sampling method for a questionnaire survey.Venous blood was collected and CD4 cell levels were detected by flow cytometry.SPSS 22.0 was used for t-test,analysis of variance and χ^(2)⁃test,and multiple linear regression analysis was used to explore the level of CD4 cells and its main influencing factors in HIV/AIDS population after HAART.[Results]Univariate analysis showed significant differences in baseline CD4 cell levels among people of different ages,nationalities,residential types and annual income(P<0.05).There were statistically significant differences in the most recent CD4 cell levels among people of different nationalities,different marital statuses,with or without regular physical exercise,with or without hypertension,different baseline CD4 cell count,different years since HIV diagnosis,different years of HAART treatment,and different treatment programs(P<0.05).Multiple linear regression analysis showed that the baseline CD4 cell count was 350‒499(t=7.40)and≥500(t=6.69),the number of years of HAART treatment was 5‒9(t=3.59)and≥10(t=4.54),the number of years of HIV diagnosis was≥10(t=−2.58),the number of people receiving second-line treatment(t=−2.49)and the latest CD4 cell levels after HAART were statistically correlated(P<0.05).[Conclusion]The CD4 cell levels of HIV/AIDS population in Xining city of Qinghai Province are affected by many factors.Comprehensive health intervention should be carried out for this population,the implementation of early detection and treatment strategy should be strengthened,relevant physiological and biochemical indicators should be monitored regularly,and health education should be carried out,so as to encourage this population group to choose a healthy lifestyle,improving their quality of life from multiple dimensions.