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目的探讨嘉兴市HIV感染者在无抗病毒治疗干预下的CD4+T淋巴细胞计数自然变化及其影响因素。方法对2008年7月-2013年6月嘉兴市无抗病毒治疗史或抗病毒治疗前至少接受过2次CD4+T淋巴细胞计数检测的HIV感染者进行回顾性队列研究,描述其计数自然变化速率,运用logistic回归分析计数显著下降的影响因素。结果共纳入研究对象293例,CD4+T淋巴细胞计数月均自然变化速率中位数为-3.6 cell/μl(IQR:-11.1~1.3)。约32.4%(95例)研究对象末次CD4+T淋巴细胞计数较首次表现为显著下降(≥30%),经logistic多因素回归分析显示,其显著下降与年龄、首次CD4+T淋巴细胞计数水平、首末次检测时间间隔存在关联。结论嘉兴市HIV感染者CD4+T淋巴细胞计数自然变化总体平缓,但部分感染者的计数下降显著与多因素有关。应定期随访HIV感染者的CD4+T淋巴细胞计数水平,以掌握病情进展并适时启动抗病毒治疗。
Objective To investigate the natural changes of CD4 + T lymphocyte count and its influencing factors in HIV-infected Jiaxing patients without antiviral treatment. Methods A retrospective cohort study was conducted on HIV-infected persons who had at least 2 CD4 + T lymphocyte count tests before or without antiviral treatment in Jiaxing City from July 2008 to June 2013. The natural changes in their counts Rate, using logistic regression analysis of the significant decline in the impact of factors. Results A total of 293 subjects were enrolled in this study. The median monthly natural rate of CD4 + T lymphocyte count was -3.6 cell / μl (IQR: -11.1-1.3). About 32.4% (95 cases) of the subjects had a significant decrease (> 30%) in CD4 + T lymphocyte count at the first time, which was significantly lower than that of age, first CD4 + T lymphocyte count , There is a correlation between the first detection interval and the last detection interval. Conclusion The natural changes of CD4 + T lymphocyte count in HIV-infected persons in Jiaxing City are generally mild, but the counts decline in some infected persons is significantly related to many factors. Should be regular follow-up HIV-infected patients with CD4 T lymphocyte count levels to grasp the progress of the disease and start antiviral therapy timely.