381例艾滋病住院患者死亡原因分析

冯瑞芳; 马烨; 刘中夫; 张福杰; 杨燕; 黄绍标; 何浩岚; 陆娟; 雷素云; 赵红心; 代丽丽; 何云

Abstract

冯瑞芳,马烨,刘中夫,张福杰,杨燕,黄绍标,何浩岚,陆娟,雷素云,赵红心,代丽丽,何云.381例艾滋病住院患者死亡原因分析[J].Chinese journal of Epidemiology,2013,34(12):1237-1241

381例艾滋病住院患者死亡原因分析

Specific causes of death among 381 AIDS patients who died in hospita

Received:June 20, 2013

DOI：10.3760/cmaj.issn.0254-6450.2013.012.019

KeyWord: 艾滋病死亡原因相关疾病抗病毒治疗

English Key Word: AIDS Cause ofdeath Related disease Antiretroviral therapy

FundProject:

Author Name	Affiliation	E-mail
Feng Ruifang	National Centerfor STD/AIDS Control and Prevention,Chinese Center of Disease Control and Prevention, Beijing 102206, China Xuzhou Eye DiseasePrevention and Research Institute
Ma Ye	National Centerfor STD/AIDS Control and Prevention,Chinese Center of Disease Control and Prevention, Beijing 102206, China
Liu Zhongfu	National Centerfor STD/AIDS Control and Prevention,Chinese Center of Disease Control and Prevention, Beijing 102206, China	zhongfuliu@163.com
Zhang Fujie	National Centerfor STD/AIDS Control and Prevention,Chinese Center of Disease Control and Prevention, Beijing 102206, China
Yang Yan	National Centerfor STD/AIDS Control and Prevention,Chinese Center of Disease Control and Prevention, Beijing 102206, China
Huang Shaobiao	Nanning Fourth People's Hospital
He Haolan	Guangzhou Eighth People'sHospital
Lu Juan	Xinjiang Uygur Autonomous Region Infectious Diseases Hospital
Lei Suyun	Yunnan InfectiousDisease Specialist Hospital
Zhao Hongxin	Beijing Ditan Hospital
Dai Lili	Beijing Youan Hospital
He Yun	Zhengzhou SixthPeople's Hospital

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Abstract:

目的了解中国部分艾滋病抗病毒治疗定点医院住院艾滋病患者的死亡原因及其相关影响因素。方法在7所省级艾滋病抗病毒治疗定点医院收集2009-2010年艾滋病住院死亡患者的死因及相关医疗信息,采用CoDe编码系统归类,应用logistic回归分析患者是否死于艾滋病相关原因的影响因素。结果7所医院共收集381例艾滋病患者的临床医疗及死因信息,患者以男性为主(82.4%),30～45岁占多数,生前曾接受抗病毒治疗(ART)者占32.3%。252例(66.1%)死于艾滋病相关原因,其中机会性感染占92.4%,以结核菌、肺孢子菌、马尔尼菲青霉菌感染为主。在非艾滋病相关死亡原因中,前三位依次是非艾滋病相关感染、肝炎、非艾滋病相关肿瘤,分别占29.5%、22.5%、10.1%。患者死亡前一年内有注射吸毒行为、未接受ART、合并机会性感染、未合并肝炎及死亡前最近一次CD₄⁺T淋巴细胞计数水平较低的病例,死于艾滋病相关原因风险较高。结论机会性感染、非艾滋病相关感染、肝炎是艾滋病患者最主要的前三位死因,接受ART的患者死于非艾滋病相关原因的风险低于未接受ART者,且治疗时间越长,死于非艾滋病相关原因的比例越低。

English Abstract:

0bjIective In this study，researchers investigated the demographic and clinicalcharacteristies of AIDS patients who died in hospitals.analyzed the specific causes of death.andlooked for the correlation between specific cause of death and their clinical characteristies.MethodsData of clinical characteristics of patients and their specific causes AIDS of death who died in theseven hospitals from 2009 to 2010 were collected retrospectively.All the specific causes ofdeath wereclassified according to the Cause of Death(CoDe)project protoc01.Univariate analysis andmultivariate logistic regression analysis were used to find the association between some categoricalvariables and the risk for AIDS patients died from AIDS related illnesses.Results Clinicacharacteristics and the cause of death of the 38 1 deceased in seven hospitals in this study werecollected.82.4%were male.with priority as 30-45 years old.1 23(32.3%)death patients hadreceived ART before death.In all death cases.the cause of death of 252 patients(66.1%)were due toAIDS related diseases。with opportunistic infections the most(92.4%).Tubercle bacillus.infection of Penicillium marneffei and Pneurnocystis firovecy were the three leading causes of opportunistic infectiondeaths.Of 129 patients who died ofnon-AIDS related disease，non.AIDS infection(29.5%).hepatitis(22.5%)，and non-AIDS malignancy(1 0.1%)were the first three causes of death.The cause of deathin patients who had injecting drug use behavior within one year。had not receivied ART or not longenough，with opportunistic infections，without hepatitis，with the last low CD₄ cell counts before death etc.were tend to due to AIDS related disease.Conclusion Opportunistic infections.non.AIDSrelated infections and hepatitis were the three leading causes of death in this study.The duration oftime on ART had impact on the patient’S cause of death.The HIV infected patients who had receivedART before death had more risk to die of non.AIDS related disease.compared to patients who hadnot.The longer time they had accessed to ART.the less likely they would die on non-AIDS relatedillnesses.

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