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目的探讨家属陪同咨询对艾滋病(AIDS)首次抗病毒治疗患者的影响。方法将首次接受抗病毒治疗的AIDS患者150例(完成128例,脱落22例)作为研究对象,其中92例(完成80例,脱落12例)有家属陪同咨询作为家属陪同组,58例(完成48例,脱落10例)无家属陪同咨询作为对照组。对照组接受系统艾滋病教育管理,家属陪同组在对照组基础上对患者家属进行系统教育干预,并利用微信、QQ、电话、门诊随访1年。统计治疗前后CD4~+T淋巴细胞计数、病毒载量变化,治疗1年后发放社会支持评定量表(SSRS)评估社会支持情况,世界卫生组织生活质量测定简表(WHOQOLBREF)评估生活质量,医学应对方式问卷(MCMQ)量表评估应对方式,了解治疗依从性,并统计1年死亡率。结果在治疗1年后两组CD4~+T淋巴细胞计数上升,病毒载量下降,与治疗前比较差异有统计学意义(P<0.05),且家属陪同组改变幅度较对照组明显(P<0.05);家属陪同组治疗依从率为91.25%高于对照组的75.0%(P<0.05);家属陪同组SSRS评分[(30.13±5.17)vs.(28.06±5.41)]、WHOQOL-BREF评分[(78.61±13.64)vs.(70.59±12.87)]、积极应对评分[(20.02±3.01)vs.(16.58±3.24)]均高于对照组,消极、屈服应对评分[(14.98±2.83)、(11.64±2.03)]低于对照组[(16.24±3.04),(13.76±2.18)](P<0.05);家属陪同组1年死亡率为1.25%低于对照组的10.47%(P<0.05)。结论家属陪同咨询可提高AIDS首次抗病毒治疗的依从性,提高CD4~+T淋巴细胞计数,降低病毒载量,提高生活质量。
Objective To explore the impact of family members accompanying counseling on the first anti-virus treatment of AIDS. Methods A total of 150 AIDS patients (128 completed and 22 come off) were enrolled in this study. 92 of them (80 completed and 12 off) were accompanied by family members and 58 were accompanied 48 cases, 10 cases off) without family members to consult as a control group. The control group received systematic AIDS education and management, and the family members accompanied by family members received systematic education intervention on the basis of the control group. Wechat, QQ, telephone and outpatients were followed up for 1 year. Before and after treatment, CD4 ~ + T lymphocyte count and viral load were measured. Social support rating scale (SSRS) was issued to evaluate social support one year after treatment. WHOQOLBREF was used to evaluate the quality of life, Coping Style Questionnaire (MCMQ) Scale to assess coping style, understand treatment compliance, and calculate 1-year mortality. Results The counts of CD4 ~ + T lymphocytes increased and the viral load decreased after one year of treatment, with statistical significance (P <0.05), and the extent of change in the accompanying families was significantly higher than that of the control group (P < (P <0.05). The compliance rate of dependents in treatment group was 91.25%, which was significantly higher than that in control group (75.0%, P <0.05). SSRS scores in family members [(30.13 ± 5.17) vs. (28.06 ± 5.41) (78.61 ± 13.64) vs. (70.59 ± 12.87), positive coping score [(20.02 ± 3.01) vs. (16.58 ± 3.24)] were significantly higher than those in the control group (P <0.05). The 1-year mortality rate was 1.25% in the family member-dependent group, which was lower than that in the control group (10.46% . Conclusion Family members accompany counseling can improve the adherence of AIDS for the first time to antiviral therapy, improve the CD4 ~ + T lymphocyte count, reduce the viral load and improve the quality of life.