Survival analysis on the influencing factors of the mortality of TB/HIV co-infectious patients during the anti-tuberculosis treatment period in Yunnan Province
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摘要: 目的 分析结核分枝杆菌/艾滋病病毒双重感染患者(mycobacterium tuberculosis and human immunodeficiency virus co-infection patients,TB/HIV)抗结核治疗期间死亡相关影响因素。方法 运用1:1配对设计的队列研究方法对TB/HIV双感染患者与普通结核患者接受标准化抗结核治疗期间死亡率差异进行比较,并对TB/HIV双感染患者进行死亡危险因素分析。结果 TB/HIV双感染患者死亡率为6.60%,普通结核患者死亡率为0.43%。对TB/HIV双感染患者进行Cox回归分析,患者病情程度、就诊延迟时间及CD4+T淋巴细胞水平是造成TB/HIV双感染患者死亡的主要影响因素(均有P<0.05)。其中,重症患者出现死亡的风险是非重症患者的2.049倍,就诊延迟≥14 d患者出现死亡的风险是就诊延迟<14 d的1.521倍,CD4+T淋巴细胞<50个/μl是≥50个/μl的2.943倍。抗病毒治疗开始时间及是否接受抗病毒治疗也是造成双感染患者死亡的影响因素。结论 通过筛查尽早发现并及时予以标准化的抗结核治疗。根据患者自身情况,对符合条件者尽早开始抗病毒治疗,提高患者的生存率,降低死亡风险。Abstract: Objective To analyze the influencing factors of the mortality of Mycobacterium tuberculosis and human immunodeficiency virus (TB/HIV) co-infection patients during the anti-tuberculosis treatment period. Methods The mortality of TB/HIV co-infection patients was compared with that of ordinary TB patients by 1:1 cohort study method during the anti-tuberculosis treatment period. Then, the influencing factors of the mortality for the TB/HIV patients. Results The mortality rate of the TB/HIV co-infection patients and ordinary TB patients were 6.60% and 0.43%, respectively. Cox regression analysis was carried out and showed that the degree of patients, clinic delay time and level of CD4+cell counts were main risk factors for the TB/HIV co-infection patients (all P<0.05). The mortality rate of the critically patients were 2.049 times more than that of other patients, the death risk of patients with visit delay for 14 days or more was 1.521 times compared with patients who delayed less than 14 days. The death risk of patients with CD4+ cell counts <50 p/μl was 2.943 times compared with the patients with CD4+ cell counts of 50 p/ul or more. In addition, the beginning time of antiviral therapy and whether to accept antiviral therapy were also influential factors. Conclusions Through early detection, providing standardized treatment in time and giving antiviral therapy to eligible persons as soon as possible, the survival rate could be improved, risk of death could be reduced, and the life of TB/HIV co-infection patients could be saved.
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Key words:
- HIV /
- Tuberculosis /
- Death
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