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目的评价德州市艾滋病抗病毒治疗的效果,为制定有针对性的艾滋病防治策略提供科学依据。方法以德州市2005-2015年所有接受艾滋病抗病毒治疗的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)为研究对象,以CD4+T淋巴细胞(简称CD4细胞)及病毒载量为客观指标,结合患者转归,综合分析抗病毒治疗的疗效。结果243例接受高效抗反转录病毒疗法(HAART)的HIV/AIDS病人,平均年龄(38.40±10.16)岁,基线CD4细胞计数均值为(239.96±161.10)个/μL,治疗后CD4细胞平均增长211.01个/μL(t=-11.604,P=0.000)。在开始治疗的36个月内,不同基线CD4细胞组计数增长存在统计学差异(F=5.701,P=0.001)。接受HAART平均时长(30.71±23.82)个月,治疗12个月病毒抑制率为88.69%(149/168),累计死亡率为7.82%(19/243)。多因素Cox比例风险回归模型分析显示,随着确证时年龄的增长,HIV/AIDS病人的死亡率增加;基线CD4细胞计数≤200个/μL的HIV/AIDS病人的死亡风险,是基线CD4细胞计数>200个/μL病人的12.683倍[95%可信区间(CI):2.769~58.079]。结论抗病毒治疗可以有效促进免疫重建。提高早期发现能力,及早采取规范的治疗措施,加强依从性教育,对于提高艾滋病抗病毒治疗效果具有重要意义。
Objective To evaluate the effect of AIDS antiviral therapy in Dezhou and provide a scientific basis for the development of targeted AIDS prevention and control strategies. Methods All HIV / AIDS patients (HIV / AIDS patients) receiving ART from 2005 to 2015 in Dezhou City were enrolled in this study. CD4 + T lymphocytes (CD4 cells for short) And viral load as an objective indicator, combined with patient outcomes, a comprehensive analysis of the efficacy of antiviral therapy. Results 243 patients with HIV / AIDS patients receiving HAART had a mean age of (38.40 ± 10.16) years and a baseline mean CD4 cell count of (239.96 ± 161.10) / μL, with an average increase of CD4 cells after treatment 211.01 pcs / μL (t = - 11.604, P = 0.000). There was a statistically significant increase in counts of CD4 cells at different baseline levels within 36 months of beginning treatment (F = 5.701, P = 0.001). The mean duration of HAART (30.71 ± 23.82) months was 88.69% (149/168) and the cumulative mortality rate was 7.82% (19/243) at 12 months. Multivariate Cox proportional hazards regression analysis showed that mortality increased with HIV / AIDS patients’ age at confirmatory confirmation; the risk of death from HIV / AIDS patients with a baseline CD4 count <200 / μL was the baseline CD4 cell count > 12.683 times [95% confidence interval (CI): 2.769-58.079] for> 200 / μL patients. Conclusion Antiviral therapy can effectively promote immune reconstitution. To improve the ability of early detection, to take normative treatment as soon as possible and to strengthen compliance education are of great significance to improve the effect of AIDS antiviral therapy.