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目的分析新疆阿克苏地区艾滋病病毒感染者/患者的死亡原因和病死率,采取有针对性的防治措施,降低艾滋病病死率,减少其他原因造成的死亡。方法依据全国艾滋病综合防治数据信息系统提供的2013年报告艾滋病病毒感染者/患者死亡病例数据信息,分析死亡原因。结果 2013年报告艾滋病病毒感染者/患者死亡病例224例,其中艾滋病相关死亡48例,艾滋病无关死亡167例,无法判定8例,死亡报告不规范1例;死亡时病程阶段为艾滋病病毒感染151例,艾滋病患者73例;艾滋病相关死亡,HIV感染确认(替代策略)检测阳性与死亡间隔时间中位数为3年3个月,间隔时间小于1年占35.42%;艾滋病无关死亡间隔时间中位数2年4个月,间隔时间小于1年占25.75%;男女性别(χ2=0.26)、异性性传播与注射吸毒(χ2=0.19)、HIV感染确认(替代策略)检测阳性与死亡各间隔时间艾滋病相关或无关死亡构成比(χ2=3.85)差异无统计学意义(P>0.05);艾滋病相关死亡直接原因中结核分枝杆菌感染(肺内)构成比最高占43.75%,其次是肺外结核病14例占29.17%;艾滋病无关死亡直接原因中其他非疾病外因死亡(损伤等)构成比最高,占20.36%,其次为呼吸系统疾病占19.16%,心脑血管疾病居第三位,占16.17%,注射毒品者吸毒过量较为常见;死亡病例中死于家中占70.30%,死亡信息收集大部分来源于患者家属或朋友占64.57%。结论各级医疗机构应当高度关注艾滋病引发死亡的原因,加强对自愿咨询检测和伴侣检测的宣传和倡导,提高检测的针对性和检测效率,加强艾滋病/结核病双重感染的防控工作,抗病毒治疗机构要注重对心脑血管疾病的医疗救助;努力完善“零歧视”的支持性社会环境。
Objective To analyze the cause of death and mortality of HIV-infected persons / patients in Aksu region of Xinjiang and take targeted prevention and control measures to reduce the AIDS-related mortality rate and reduce the death caused by other causes. Methods Based on the data from the 2013 HIV / AIDS-related deaths reported by the National AIDS Prevention and Control Information System, the causes of death were analyzed. Results In 2013, 224 cases of HIV / AIDS were reported, of which 48 were AIDS-related deaths, 167 were AIDS-unrelated ones, 8 were undetectable and 1 were not standardized. The death course was HIV-infected in 151 cases , AIDS patients 73 cases; AIDS-related deaths, HIV infection confirmed (alternative strategies) test positive and the median interval between deaths was 3 years and 3 months, interval less than 1 year accounted for 35.42%; AIDS-related median death interval (Χ2 = 0.26), heterosexual transmission and injecting drug abuse (χ2 = 0.19), HIV infection confirmed (alternative strategy) positive and death test at various intervals AIDS (Χ2 = 3.85), there was no significant difference between the two groups (χ2 = 3.85) (P> 0.05). The direct cause of AIDS-related death was the highest proportion of M. tuberculosis (43.75%), followed by extra-pulmonary tuberculosis Accounting for 29.17% of all cases; the highest proportion of non-AIDS-related deaths (injuries, etc.) accounted for 20.36%, followed by respiratory diseases accounted for 19.16%, cardiovascular and cerebrovascular diseases ranked third, accounting for 16.17% Who shoot drugs overdose is more common; deaths died at home accounted for 70.30%, most of death information gathered from family or friends of patients accounted for 64.57%. Conclusion Medical institutions at all levels should pay close attention to the causes of death caused by AIDS, strengthen the publicity and advocacy of voluntary counseling and testing and partner testing, improve the pertinence and efficiency of testing, strengthen the prevention and control of HIV / TB dual infection, and prevent and treat antiviral treatment Organizations should pay attention to the medical rescue of cardiovascular and cerebrovascular diseases and strive to perfect the supportive social environment of “zero discrimination”.