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目的调查接受艾滋病抗病毒治疗患者的生存质量和生存时间,探讨其影响因素。方法收集2005年1月1日—2015年12月31日在惠州市随访并接受艾滋病抗病毒治疗的639例患者信息,采用SF-36量表对患者进行生存质量调查,分析影响患者生存质量及生存时间的因素。结果研究对象的生理机能、社会功能、生理职能、情感职能、精神健康、精力、躯体疼痛、一般健康状况的得分明显低于常模,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示个人年收入高是生存质量的保护因素,年龄大、副反应、WHO分期高是生存质量的危险因素。Cox比例风险模型结果显示:以CD4+T淋巴细胞计数≥200个/mm3为参照,CD4+T淋巴细胞计数<50个/mm3的患者死于艾滋病相关疾病的风险为5.387(95%CI:1.673~17.483),50个/mm3≤CD4+T淋巴细胞计数<200个/mm3的患者的风险为3.607(95%CI:1.201~11.084);出现持续或间断发热患者的风险为2.147(95%CI:1.304~4.042)。结论艾滋病抗病毒治疗患者的生存质量低于一般人群,影响生存质量的因素有年龄、年收入、副反应、WHO分期。结合生存时间分析,尽早开始标准化治疗有利于患者的生存预后。
Objective To investigate the quality of life and survival time of patients receiving ART and explore the influencing factors. Methods The data of 639 patients who were followed up from January 1, 2005 to December 31, 2015 in Huizhou were enrolled in this study. The quality of life of the patients was analyzed by SF-36 scale, Factors of survival time. Results The scores of physical function, social function, physiological function, emotional function, mental health, energy, somatic pain and general health of the study subjects were significantly lower than those of the norm. The difference was statistically significant (P <0.05). Multivariate logistic regression analysis showed that high individual annual income is the protective factor of quality of life. The age, side effects and WHO stage are the risk factors of quality of life. The Cox proportional hazards model showed that the risk of dying from AIDS-related diseases was 5.387 (95% CI: 1.673) for CD4 + T lymphocyte counts> 200 / mm3 for CD4 + T lymphocyte counts <50 / ~ 17.483). The risk for patients with 50 / mm3≤CD4 + T lymphocyte counts less than 200 / mm3 was 3.607 (95% CI: 1.201-11.084). The risk for patients with persistent or intermittent fever was 2.147 (95% CI : 1.304 ~ 4.042). Conclusion The quality of life of AIDS patients is lower than that of the general population. The factors affecting the quality of life are age, annual income, side effects and WHO staging. Combined with survival analysis, as soon as possible standardized treatment is conducive to the prognosis of patients with survival.