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目的分析郑州市艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)抗病毒治疗(ART)不同时期生存情况的变化。方法采用回顾性队列研究。共3 014例符合标准的病例,依据不同抗病毒治疗时间分成国家艾滋病防治规划“十五”(2004-2005)、“十一五”(2006-2010年)、“十二五”(2011-2015年)3个治疗时期。这3个时期新增治疗病例分别为71例、954例和1 989例,由此组成3个组,比较分析3组病例的基本情况和生存状况,SPSS 23.0软件统计分析。结果不同抗病毒治疗时期,入组治疗患者的性别、年龄、职业、HIV感染途径、基线CD4+T淋巴细胞数及首治抗病毒治疗方案差异均有统计学意义(P<0.05)。十二五期间ART病人五年生存率(0.91)高于十一五期间ART病人(0.80),而十一五期间ART病人两年生存率(0.87)高于十五期间ART病人(0.67)。十五、十一五、十二五期间艾滋病病死率分别是28.89/100人年、5.61/100人年和2.66/100人年,不同治疗时期ART病人生存时间的差异有统计学意义(χ2=72.08,P<0.01);相对于十五期间,十一五、十二五期间艾滋病死亡风险分别下降了0.377倍和0.162倍。结论随着对艾滋病防治工作力度的加大,HIV/AIDS病人生存率显著提高,病死率及死亡风险明显下降,艾滋病抗病毒治疗工作取得显著成效。
Objective To analyze the changes of survival in different periods of antiviral therapy (ART) in Zhengzhou patients with HIV / AIDS (referred to as HIV / AIDS patients). Methods Retrospective cohort study. A total of 3 014 cases of standard cases, according to different antiviral treatment time is divided into national AIDS prevention and control programs “fifteen” (2004-2005), “Eleventh Five-Year” (2006-2010), “twelve Five ”(2011-2015) three treatment periods. The three new treatment cases were 71 cases, 954 cases and 1 989 cases, which formed the three groups, comparative analysis of the three groups of cases of basic conditions and living conditions, SPSS 23.0 software statistical analysis. Results There were significant differences in the gender, age, occupation, HIV infection, baseline CD4 + T lymphocyte count and the first antiviral treatment regimen among the patients treated in the different antiviral treatment periods. The five-year survival rate (0.91) for ART patients during the twelfth five-year period was higher than that for the ART patients during the eleventh five-year period (0.80). The two-year survival rate (0.87) for ART patients during the 11th five-year period was higher than that for ART patients during the fifteen period (0.67). The AIDS death rates during the 15th, 11th and 12th five-year plan period were 28.89 / 100 person-years, 5.61 / 100 person-years and 2.66 / 100 person-years respectively. There was significant difference in the survival time of ART patients between different treatment periods (χ2 = 72.08, P <0.01). Compared with the fifteen periods, the risk of AIDS death decreased by 0.377 times and 0.162 times respectively during the 11th and 12th five-year period. Conclusion With the intensification of HIV / AIDS prevention and treatment efforts, the survival rate of HIV / AIDS patients was significantly increased, the mortality rate and death risk were significantly decreased, and AIDS anti-virus treatment achieved remarkable results.