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[目的]探讨上海市2个区未接受抗病毒治疗的艾滋病病毒(HIV)感染者CD+4T淋巴细胞计数的自然变化特征及其影响因素。[方法]对1987—2013年5月期间上海市2个城区报告的未接受抗病毒治疗,或抗病毒治疗前至少有2次CD+4T淋巴细胞计数结果的HIV感染者开展回顾性研究,描述CD+4T淋巴细胞计数自然变化特征,并分析其显著下降的影响因素。[结果]共纳入调查对象365例,CD+4T淋巴细胞计数月均自然变化速率的中位数M=-4.4(IQR:-11.1~0.2)个/μL,其中263例(72.1%)HIV感染者末次CD+4T淋巴细胞计数结果低于首次,显著下降(≥30%)率为39.2%(143/365)。Logistic多因素回归分析结果显示:HIV感染者CD+4T淋巴细胞计数显著下降率与年龄、首次CD+4T淋巴细胞计数水平及首末次CD+4T淋巴细胞计数检测间隔时间存在统计学关联。[结论]HIV感染者治疗前CD+4T淋巴细胞计数自然变化总体平缓,部分感染者CD+4T淋巴细胞计数快速下降与多种因素相关。应定期监测CD+4T淋巴细胞计数水平和变化速率,及时评估病情进展,开展有针对性的行为干预和临床干预。
[Objective] To investigate the natural variation characteristics of CD + 4T lymphocyte count in HIV-infected patients in two districts of Shanghai and its influencing factors. [Methods] A retrospective study was conducted on HIV-infected patients who reported no antiretroviral therapy in two municipal districts of Shanghai during May 1987-May 2013 or at least 2 CD + 4T lymphocyte count results prior to antiviral therapy. CD + 4T lymphocyte count characteristics of natural changes, and analysis of the significant decline in the influencing factors. [Results] A total of 365 patients were enrolled in this study. The median monthly natural rate of CD + 4T lymphocyte count was M = -4.4 (IQR: -11.1 ~ 0.2) / μL, of which 263 (72.1% The last CD + 4T lymphocyte count results were lower than the first, with a significant decrease (≥30%) rate of 39.2% (143/365). Logistic regression analysis showed that the significant decrease rate of CD + 4T lymphocyte count in HIV-infected patients was statistically associated with the age, the first CD + 4T lymphocyte count and the first and last CD + 4T lymphocyte count interval. [Conclusion] The natural changes of CD + 4T lymphocyte count before treatment in HIV-infected patients are generally mild. The rapid decline of CD + 4T lymphocyte count in some infected patients is correlated with many factors. Should be regularly monitored CD + 4T lymphocyte count levels and rate of change, timely assessment of disease progression, to carry out targeted behavioral intervention and clinical intervention.