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目的探讨首次基线抗逆转录病毒药物(ART)疗效不满意的影响因素,为提高抗病毒治疗效果提供依据。方法选取排除机会性感染和恶性肿瘤的艾滋病且疗效不满意的52例患者为实验组,选取同期性别、年龄、病期和治疗方案相仿,疗效满意患者为对照组。观察其患病年龄、性行为特征(同性性行为、商业性行为、性交带安全套、每周性交次数、性道德观)、HIV知晓、CD4+T细胞计数、依从性、合并感染、临床分期、治疗方案和感染途径等的发生率和OR值。结果药物滥用(DA)、合并感染、治疗初CD4+T细胞计数、感染后治疗时间和依从性等是疗效不满意的重要危险因素(P<0.01),DA、合并感染、治疗初CD4+T细胞计数在50以下、感染37个月以上才开始治疗和不依从性患者的疗效不满意风险分别是8.5,5.2,2.7,0.2和0.1倍。结论 AIDS患者的体质、行为、感染的程度、感染的期限和规范用药等因素对ART的效果有影响,早期规范治疗、增强患者的体质、控制合并感染和不吸毒者,对提高ART的效果有益。
Objective To explore the unsatisfactory factors of the efficacy of the first baseline antiretroviral drug (ART) and provide the basis for improving the anti-viral treatment effect. Methods Fifty-two patients, who were excluded from opportunistic infections and malignant tumors and were not satisfied with the treatment, were selected as the experimental group. The sex, age, disease duration and treatment plan were similar in the same period. Patients with satisfactory efficacy were selected as the control group. The age, sex characteristics (same-sex behavior, commercial sex, condoms, weekly sexual intercourse, sexual morality), HIV awareness, CD4 + T cell count, compliance, Treatment options and routes of infection such as the incidence and OR values. Results DA, co-infection, CD4 + T cell count at the beginning of treatment, treatment time and compliance after infection were important risk factors for unsatisfactory response (P <0.01). DA, co-infection, CD4 + T Cellular count below 50, more than 37 months of infection before treatment and non-compliance of the efficacy of the patients are not satisfied with the risk of 8.5,5.2,2.7,0.2 and 0.1 times. Conclusion The factors such as body constitution, behavior, infection level, duration of infection and normative medication of AIDS patients have an impact on the efficacy of ART. Early standardized treatment, enhancing the patient’s constitution, controlling the co-infection and non-drug users are beneficial to the improvement of the effect of ART .