文章摘要
杨跃诚,段松,项丽芬,叶润华,龚渝蓉,杨世江,高洁,杨忠桔,韩文香,李洲林,濮永成,杨建华,曹东冬,李维关,何纳.云南省德宏州1 989--20 1 1年HIV感染者死亡率及其影响因素研究[J].中华流行病学杂志,2012,33(10):1026-1030
云南省德宏州1 989--20 1 1年HIV感染者死亡率及其影响因素研究
Study on the mortality and risk factors among HIV,infected individuals during 1989-201 1 in Dehong prefecture,Yunnan province
投稿时间:2012-05-11  
DOI:
中文关键词: 艾滋病毒感染者;死广率;影响因素;回顾性队列研究
英文关键词: HIV-infected individuals;Mortality;Influencing factors;Retrospective cohort study
基金项目:国家“十~五”科技重大专项(2008ZXl0001-003,2008ZXl0001-016);国家自然科学基金(81072345)
作者单位E-mail
杨跃诚 云南省德宏州疾病预防控制中心, 芒市 678400  
段松 云南省德宏州疾病预防控制中心, 芒市 678400  
项丽芬 云南省德宏州疾病预防控制中心, 芒市 678400  
叶润华 云南省德宏州疾病预防控制中心, 芒市 678400  
龚渝蓉 云南省德宏州疾病预防控制中心, 芒市 678400  
杨世江 云南省德宏州疾病预防控制中心, 芒市 678400  
高洁 云南省德宏州疾病预防控制中心, 芒市 678400  
杨忠桔 瑞丽市疾病预防控制中心  
韩文香 陇川县疾病预防控制中心  
李洲林 瑞丽市疾病预防控制中心  
濮永成 陇川县疾病预防控制中心  
杨建华 盈江县疾病预防控制中心  
曹东冬 芒市疾病预防控制中心  
李维关 梁河县疾病预防控制中心  
何纳 复旦大学公共卫生学院流行病学教研室公共卫生安全教育部重点实验室 nhe@shmu.edu.cn 
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中文摘要:
      
目的
了解1989-2011年云南省德宏州HIV感染者死亡率及其影响因素。方法以德宏州1989-2011年报告的所有现住址为本地的HIV感染者为研究对象,收集其死产相关信息,计算死亡率和累积生存率,并应用Cox比例风险同归模型分析死亡的影响因素。结果共有13006例H1V感染者纳入分析,男性占73.2%,农民占79.1%,48.%已婚有配偶,少数民族占64.5%,68.7%为文盲或小学文化程度。研究对象累计观察55962.30人年,死4648人,死亡率为8.31/100人年。死亡率在1990--2004年间总体呈上升趋势,自2005年起开始持续下降。研究对象白报告发现HIV感染至观察期末的平均生存时间为9.48年,其中,接受过抗病毒治疗者的平均生存时间为16.65年,而从未接受过抗病毒治疗者的平均生存时间为7.67年。多因素分析显示抗病毒治疗以及年龄、性别、民族、职业、婚姻状况和文化程度等社会人口学因素显著影响HIV感染者的死亡和生存状态。结论包括抗病毒治疗在内的艾滋病综合防治措施有效地降低r德宏州HIV感染者的死亡率,今后仍需扩大抗病毒治疗覆盖面,并针对HIV感染者的社会人口学特征加强分类管理和随访,以减少HIV感染者死亡。
英文摘要:
      Objective To examine the mortality and risk factors among HlV-infected patients during 1 989-20 1l in Dehong prefecture,Yunnan province.Methods All HIV-infected patients reported during 1 989-20 1 1 in Dehong prefecture who held local residency were included in the study.Mortality rates and cumulative survival rates were calculated.Multiple regression analysis under COX proportional hazard model was conducted to examine the risk factors for deaths,Results A total of 13006 HIV-infected patients were included in this study including 73.2%males,79.I%peasantsand 48.7%married at the time of reporting.64.5%of the patients were ethnic minorities,and 68.7%were illiterate or having received only primary school education.A1l the patients were followed-uD for a total of 55 962.30 person-years with 4648 patients died.with overall mortality rate as 8.3l/100 person-years.The mortality rate had been increasing from 1 990 to 2004 but decreasing since 2005.The average survival time since the identification of HIV infection was 9.48 years overall,and was 16.65 years for those having received antiretroviraI treatment(ART)and 7.67 years for those without ART.Data from multiple regression analysis indicated that ART and socio-demographic characteristics such as age,gender,ethnicity,occupation,marital status,education background etc,were significantly associated with death among HIV-infected patients.ConclusionThe comprehensive AIDS campaigns including ART had significantly reduced the deaths among HIV-infected patients in Dehong prefecture More efforts on the scaling up program of ART as well as the enhancedmanagement and follow-uD program tailored for HIV-infected patients with different socio-demographic characteristics were needed to further reduce the deaths in the area.
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