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Article(id=1241342457602961430, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241342451043061769, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202311326, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1700064000000, receivedDateStr=2023-11-16, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773888704919, onlineDateStr=2026-03-19, pubDate=1708790400000, pubDateStr=2024-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773888704919, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773888704919, creator=13701087609, updateTime=1773888704919, updator=13701087609, issue=Issue{id=1241342451043061769, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773888703356, creator=13701087609, updateTime=1773893026321, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241360582939562716, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241342451043061769, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241360582939562717, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241342451043061769, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=589, endPage=594, ext={EN=ArticleExt(id=1241342458865446955, articleId=1241342457602961430, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analyses on death trend and influencing factors of HIV/AIDS patients, Shandong, 2013-2022, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the death trend of HIV/AIDS patients in Shandong Province from 2013 to 2022, andto explore the related influencing factors.

Methods

A total of 25 181 HIV/AIDS patients living in Shandong Province from 2013 to 2022 were selected as the study objects, demographic characteristics, antiretroviral therapy and causes of death were collected. Study objects were divided into three groups: survival, AIDS-related death and non-AIDS-related death. Kruskal-Wallis test and χ2 test were conducted for inter group comparison, Joinpoint regression model was used to analyze the trend change of mortality, and unordered multicategorical logistic regression was used to analyze HIV/AIDS death and its influencing factors.

Results

From 2013 to 2022, a total of 1 187 HIV/AIDS patients deaths were reported in Shandong Province, among which AIDS-related deaths accounted for 34.63% and non-AIDS-related deaths accounted for 65.37%. The mortality rates showed a decreasing trend (APC was -13.58, -20.29, and -9.67, respectively, all P<0.05). Unordered multicategorical logistic regression analysis showed that the time from diagnosis to ART initiation greater than 30 days, WHO clinical stage Ⅱ, Ⅲ, and Ⅳ were the risk factors for AIDS-related death of HIV/AIDS patients, and the OR (95% CI) values were 1.74(1.41-2.16), 1.93(1.38-2.70), 2.61(1.87-3.63) and 4.81(3.71-6.23); the time from diagnosis to ART initiation greater than 30 days, male, farmer and heterosexual transmission were the risk factors for non-AIDS-related death of HIV/AIDS patients, with OR (95% CI) values of 2.10(1.79-2.46), 1.75(1.38-2.20), 1.60(1.28-2.01), and 1.75(1.48-2.08).

Conclusion

From 2013 to 2022, the case fatality rate of HIV/AIDS patients in Shandong Province has shown a downward trend after the start of ART, the age of death increased, and the case fatality rate of non-AIDS-related deaths is generally higher than that of AIDS-related deaths. There are differences in the influencing factors for AIDS-related and non-AIDS-related deaths, and targeted interventions should be developed.

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目的

了解山东省2013—2022年艾滋病病毒感染者和艾滋病病人（HIV/AIDS）的死亡趋势，并探讨相关影响因素。

方法

以2013—2022年现住址为山东省的25 181例HIV/AIDS患者为研究对象，收集研究对象的人口学特征、抗病毒治疗以及死亡原因等信息，根据生存状况将患者分为存活、艾滋病相关死亡和非艾滋病相关死亡三组，采用Kruskal-Wallis检验、χ2检验等进行组间比较，Joinpoint回归模型进行病死率趋势变化分析，并应用无序多分类logistic回归模型对HIV/AIDS患者死亡及其影响因素进行分析。

结果

山东省2013—2022年共报告HIV /AIDS患者死亡病例1 187例，其中艾滋病相关死亡占34.63%，非艾滋病相关死亡占65.37%，病死率呈逐年下降趋势（APC分别为-13.58,-20.29和-9.67，均P<0.05）。无序多分类logistic回归分析结果显示：确诊到开始ART时间>30天、WHO临床分期为Ⅱ、Ⅲ和Ⅳ是HIV/AIDS患者发生艾滋病相关死亡的危险因素，OR (95% CI)值分别为1.74（1.41~2.16）、1.93(1.38~2.70)、2.61(1.87~3.63)和4.81(3.71~6.23)；确诊到开始ART时间>30天、男性、农民和异性传播是HIV/AIDS患者发生非艾滋病相关死亡的危险因素，OR (95% CI)值分别为2.10（1.79~2.46）、1.75(1.38~2.20)、1.60(1.28~2.01)和1.75(1.48~2.08)。

结论

2013—2022年山东省HIV/AIDS患者开始ART后病死率呈下降趋势，死亡年龄增加，发生非艾滋病相关死亡的病死率总体高于艾滋病相关死亡。艾滋病相关死亡和非艾滋病相关死亡的影响因素存在一定差异，应制定有针对性的干预措施。

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刘云霞，Email：；
张娜，Email：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Z/XBCxwxowQFlRi8tYy8Kw==, magXml=FP3p7kHQiiEMzhx+5UqUdA==, pdfUrl=null, pdf=hc9gCB8nKjjjoS2hK8c9Jw==, pdfFileSize=1006039, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=OaGkJX/IIf+piZQzyjHSNw==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=UF4UjslH9itpfiqdmj2hag==, mapNumber=null, authorCompany=null, fund=null, authors=

宋怡宁（1999—），女，硕士在读，研究方向：艾滋病流行病学

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2. 山东大学健康医疗大数据研究院, bio={"content":"

宋怡宁（1999—），女，硕士在读，研究方向：艾滋病流行病学

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宋怡宁（1999—），女，硕士在读，研究方向：艾滋病流行病学

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2. 山东大学健康医疗大数据研究院
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2. 山东大学健康医疗大数据研究院
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Survival time and influencing factors of HIV/AIDS cases in Xinxiang, Henan, 1995-2019[J].Henan Journal of Preventive Medicine, 2022, 33(1): 44-48., articleTitle=Survival time and influencing factors of HIV/AIDS cases in Xinxiang, Henan, 1995-2019, refAbstract=null), Reference(id=1241359979639263957, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, doi=null, pmid=null, pmcid=null, year=2023, volume=39, issue=12, pageStart=1682, pageEnd=1685, 1690, url=null, language=null, rfNumber=[19], rfOrder=28, authorNames=赵塔娜, 曾茵茹, 李文瑞, journalName=职业与健康, refType=null, unstructuredReference=赵塔娜，曾茵茹，李文瑞，等．我国HIV感染者/AIDS患者晚发现发生率及影响因素的meta分析[J]．职业与健康，2023，39（12）：1682-1685, 1690．, articleTitle=我国HIV感染者/AIDS患者晚发现发生率及影响因素的meta分析, refAbstract=null), Reference(id=1241359979697984215, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, doi=null, pmid=null, pmcid=null, year=2023, volume=39, issue=12, pageStart=1682, pageEnd=1685, 1690, url=null, language=null, rfNumber=[19], rfOrder=29, authorNames=Zhao TN, Zeng YR, Li WR, journalName=Occupation and Health, refType=null, unstructuredReference=Zhao TN, Zeng YR, Li WR, et al. 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Occupation and Health, 2023, 39(12): 1682-1685, 1690., articleTitle=A meta-analysis of prevalence and influencing factors of late detection of HIV infections/AIDS cases in China, refAbstract=null), Reference(id=1241359979765093081, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, doi=null, pmid=null, pmcid=null, year=2021, volume=48, issue=22, pageStart=4063, pageEnd=4067, 4084, url=null, language=null, rfNumber=[20], rfOrder=30, authorNames=何世娇, 施雅莹, 代珍, journalName=现代预防医学, refType=null, unstructuredReference=何世娇，施雅莹，代珍，等．成都市1992—2019年HIV/AIDS死亡率及影响因素分析[J]．现代预防医学，2021，48（22）：4063-4067, 4084．, articleTitle=成都市1992—2019年HIV/AIDS死亡率及影响因素分析, refAbstract=null), Reference(id=1241359979836396251, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, doi=null, pmid=null, pmcid=null, year=2021, volume=48, issue=22, pageStart=4063, pageEnd=4067, 4084, url=null, language=null, rfNumber=[20], rfOrder=31, authorNames=He SJ, Shi YY, Dai Z, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=He SJ, Shi YY, Dai Z, et al. Mortality and risk factors of HIV/AIDS cases in Chengdu from 1992 to 2019[J]. Modern Preventive Medicine, 2021, 48(22): 4063-4067, 4084., articleTitle=Mortality and risk factors of HIV/AIDS cases in Chengdu from 1992 to 2019, refAbstract=null)], funds=[Fund(id=1241359975705006734, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, awardId=ZR2014HQ038, language=CN, fundingSource=山东省自然科学基金(ZR2014HQ038), fundOrder=null, country=null), Fund(id=1241359975788892817, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, awardId=2019WS438, language=CN, fundingSource=山东省医药卫生科技发展计划(2019WS438), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241359967362535864, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, xref=1., ext=[AuthorCompanyExt(id=1241359967375118777, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, companyId=1241359967362535864, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China), AuthorCompanyExt(id=1241359967383507386, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, companyId=1241359967362535864, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.山东大学齐鲁医学院公共卫生学院生物统计学系， 山东 济南 250012)]), AuthorCompany(id=1241359967459004861, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, xref=2., ext=[AuthorCompanyExt(id=1241359967467393471, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, companyId=1241359967459004861, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2. 山东大学健康医疗大数据研究院)]), AuthorCompany(id=1241359967555473858, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, xref=3., ext=[AuthorCompanyExt(id=1241359967559668163, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, companyId=1241359967555473858, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3. 山东省疾病预防控制中心)]), AuthorCompany(id=1241359967643554247, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, xref=4., ext=[AuthorCompanyExt(id=1241359967651942855, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, companyId=1241359967643554247, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4. 山东大学预防医学研究院)]), AuthorCompany(id=1241359967760994761, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, xref=5., ext=[AuthorCompanyExt(id=1241359967769383370, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, companyId=1241359967760994761, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=5. 潍坊医学院)])], figs=[ArticleFig(id=1241359974396383859, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=EN, label=Fig.1, caption=Death trends of HIV/AIDS patients in Shandong Province from 2013 to 2022, figureFileSmall=LuvQ7H4SHtS7jloe5T+TfQ==, figureFileBig=vO7d1MBK5pb1IstSrDkgSw==, tableContent=null), ArticleFig(id=1241359974501241460, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=CN, label=图1, caption=2013年—2022年山东省HIV/AIDS患者的死亡变化趋势, figureFileSmall=LuvQ7H4SHtS7jloe5T+TfQ==, figureFileBig=vO7d1MBK5pb1IstSrDkgSw==, tableContent=null), ArticleFig(id=1241359974639653496, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=EN, label=Table 1, caption=

Comparison of baseline data of HIV/AIDS patients survivors and deaths in Shandong Province from 2013 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
变量存活病例（n=23 994）艾滋病相关死亡病例（n=411）非艾滋病相关死亡病例（n=776）χ2/H值P值
性别[n(%)]22.245<0.001
女2 229(9.29)56(13.63)103(13.27)
男21 765(90.71)355(86.37)673(86.73)
确诊年龄 [岁，M（P25，P75)]d33(26, 43)40(32, 51)44(32, 55)753.050a<0.001
确诊到ART时间 [d,n(%)]56.503<0.001
≤3012 403(51.69)192(46.72)298(38.40)
>3011 591(48.31)219(53.28)478(61.60)
受教育程度[n(%)]321.230a<0.001
初中及以下9 470(39.47)250(60.83)511(65.85)
高中或中专6 263(26.10)110(26.76)153(19.72)
大专及以上8 261(34.43)51(12.41)112(14.43)
职业[n(%)]345.020<0.001
固定职业b5 165(21.53)83(20.19)130(16.75)
流动职业c8 917(37.16)105(25.55)176(22.68)
农民6 374(26.56)180(43.80)418(53.87)
其他3538(14.75)43(10.46)52(6.70)
婚姻状况[n(%)]202.990<0.001
未婚11 215(46.74)119(28.95)188(24.23)
已婚有配偶8 539(35.39)186(45.26)398(51.29)
离异或丧偶4 240(17.67)106(25.79)190(24.48)
感染途径[n(%)]326.990<0.001
同性传播17 198(71.68)230(55.96)359(46.26)
异性传播6 387(26.62)163(39.66)366(47.16)
其他409(1.70)18(4.38)51(6.57)
WHO临床分期[n(%)]471.000a<0.001
Ⅰ19 912(82.99)185(45.01)537(69.20)
Ⅱ1 765(7.36)46(11.19)77(9.92)
Ⅲ1 092(4.55)52(12.65)89(11.47)
Ⅳ1 225(5.11)128(31.14)73(9.41)
治疗方案[n(%)]321.330<0.001
TDF/AZT+3TC+EFV16 802(70.03)254(61.80)507(65.34)
TDF/AZT+3TC+NVP1 199(5.00)55(13.38)122(15.72)
TDF/AZT+3TC+克力芝1 874(7.81)65(15.82)93(11.98)
其他4 119(17.17)37(9.00)54(6.96)
基线CD4细胞水平(个/μl)[n(%)]626.660a<0.001
0~2005 482(22.85)288(70.07)363(46.78)
>200~3506 262(26.10)49(11.92)174(22.42)
>350~5006 029(25.13)39(9.49)117(15.08)
>5006 221(25.93)35(8.52)122(15.72)
), ArticleFig(id=1241359974719345274, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=CN, label=表1, caption=

2013—2022年山东省HIV/AIDS患者中存活病例和死亡病例的基线资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
变量存活病例（n=23 994）艾滋病相关死亡病例（n=411）非艾滋病相关死亡病例（n=776）χ2/H值P值
性别[n(%)]22.245<0.001
女2 229(9.29)56(13.63)103(13.27)
男21 765(90.71)355(86.37)673(86.73)
确诊年龄 [岁，M（P25，P75)]d33(26, 43)40(32, 51)44(32, 55)753.050a<0.001
确诊到ART时间 [d,n(%)]56.503<0.001
≤3012 403(51.69)192(46.72)298(38.40)
>3011 591(48.31)219(53.28)478(61.60)
受教育程度[n(%)]321.230a<0.001
初中及以下9 470(39.47)250(60.83)511(65.85)
高中或中专6 263(26.10)110(26.76)153(19.72)
大专及以上8 261(34.43)51(12.41)112(14.43)
职业[n(%)]345.020<0.001
固定职业b5 165(21.53)83(20.19)130(16.75)
流动职业c8 917(37.16)105(25.55)176(22.68)
农民6 374(26.56)180(43.80)418(53.87)
其他3538(14.75)43(10.46)52(6.70)
婚姻状况[n(%)]202.990<0.001
未婚11 215(46.74)119(28.95)188(24.23)
已婚有配偶8 539(35.39)186(45.26)398(51.29)
离异或丧偶4 240(17.67)106(25.79)190(24.48)
感染途径[n(%)]326.990<0.001
同性传播17 198(71.68)230(55.96)359(46.26)
异性传播6 387(26.62)163(39.66)366(47.16)
其他409(1.70)18(4.38)51(6.57)
WHO临床分期[n(%)]471.000a<0.001
Ⅰ19 912(82.99)185(45.01)537(69.20)
Ⅱ1 765(7.36)46(11.19)77(9.92)
Ⅲ1 092(4.55)52(12.65)89(11.47)
Ⅳ1 225(5.11)128(31.14)73(9.41)
治疗方案[n(%)]321.330<0.001
TDF/AZT+3TC+EFV16 802(70.03)254(61.80)507(65.34)
TDF/AZT+3TC+NVP1 199(5.00)55(13.38)122(15.72)
TDF/AZT+3TC+克力芝1 874(7.81)65(15.82)93(11.98)
其他4 119(17.17)37(9.00)54(6.96)
基线CD4细胞水平(个/μl)[n(%)]626.660a<0.001
0~2005 482(22.85)288(70.07)363(46.78)
>200~3506 262(26.10)49(11.92)174(22.42)
>350~5006 029(25.13)39(9.49)117(15.08)
>5006 221(25.93)35(8.52)122(15.72)
), ArticleFig(id=1241359974794842748, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=EN, label=Table 2, caption=

Basic characteristics of HIV/AIDS patients in Shandong Province from 2013 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
年份总例数a年龄(岁)b艾滋病相关死亡非艾滋病相关死亡
例数病死率(%)年龄(岁)b例数病死率(%)年龄(岁)b
20131 85237(30,44)271.4643(31,50)261.4045(39,56)
20142 87736(29,45)331.1535(28,44)351.2243(38,51)
20154 72935(28,44)470.9939(34,47)531.1245(38,52)
20166 74234(28,44)360.5348(37,55)681.0144(35,55)
20179 11235(29,44)340.3741(32,45)590.6548(35,62)
201812 21335(29,44)360.2939(33,51)800.6642(32,54)
201914 96436(30,46)590.3945(37,57)1080.7249(38,62)
202017 58036(30,47)510.2944(36,56)1030.5949(38,59)
202120 61437(31,48)470.2345(36,55)1150.5648(36,58)
202224 10038(32,48)410.1747(40,54)1290.5453(41,65)
), ArticleFig(id=1241359974895506046, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=CN, label=表2, caption=

2013—2022年山东省HIV/AIDS患者的基本特征

, figureFileSmall=null, figureFileBig=null, tableContent=
年份总例数a年龄(岁)b艾滋病相关死亡非艾滋病相关死亡
例数病死率(%)年龄(岁)b例数病死率(%)年龄(岁)b
20131 85237(30,44)271.4643(31,50)261.4045(39,56)
20142 87736(29,45)331.1535(28,44)351.2243(38,51)
20154 72935(28,44)470.9939(34,47)531.1245(38,52)
20166 74234(28,44)360.5348(37,55)681.0144(35,55)
20179 11235(29,44)340.3741(32,45)590.6548(35,62)
201812 21335(29,44)360.2939(33,51)800.6642(32,54)
201914 96436(30,46)590.3945(37,57)1080.7249(38,62)
202017 58036(30,47)510.2944(36,56)1030.5949(38,59)
202120 61437(31,48)470.2345(36,55)1150.5648(36,58)
202224 10038(32,48)410.1747(40,54)1290.5453(41,65)
), ArticleFig(id=1241359974991975041, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=EN, label=Table 3, caption=

Distribution of causesof non-AIDS-related deaths in HIV/AIDS patients in Shandong Province, 2013—2022 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年份恶性肿瘤心血管疾病丙型或乙型肝炎呼吸系统疾病消化系统疾病自杀伤害其他原因合计
20133(11.54)8(30.77)3(11.54)2(7.69)0(0.00)4(15.38)3(11.54)3(11.54)26
20149(25.72)7(20.00)2(5.71)2(5.71)1(2.86)2(5.71)5(14.29)7(20.00)35
201514(26.42)7(13.21)3(5.66)4(7.55)1(1.89)5(9.43)8(15.09)11(20.75)53
201613(19.12)15(22.06)0(0.00)6(8.82)7(10.30)4(5.88)4(5.88)19(27.94)68
201715(25.43)17(28.81)2(3.39)3(5.08)3(5.08)5(8.48)4(6.78）10(16.95）59
201817(21.25)14(17.50)1(1.25)8(10.00)1(1.25)5(6.25)6(7.50)28(35.00）80
201922(22.37)21(19.44)3(2.78)10(9.26)2(1.85)6(5.56)13(12.04)31(28.70)108
202020(19.42)21(20.39)2(1.94)14(13.59)3(2.91)7(6.80)3(2.91)33(32.04)103
202119(16.52)23(20.00)4(3.48)8(6.96)3(2.61)7(6.09)14(12.17)37(32.17)115
202232(24.80)26(20.15)1(0.78)11(8.53)1(0.78)3(2.33)10(7.75)45(34.88)129
合计164(21.13)159(20.49)21(2.71)68(8.76)22(2.83)48(6.19)70(9.02)224(28.87)776
), ArticleFig(id=1241359975096832644, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=CN, label=表3, caption=

2013—2022年山东省HIV/AIDS患者中非艾滋病相关死亡的死因分布[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年份恶性肿瘤心血管疾病丙型或乙型肝炎呼吸系统疾病消化系统疾病自杀伤害其他原因合计
20133(11.54)8(30.77)3(11.54)2(7.69)0(0.00)4(15.38)3(11.54)3(11.54)26
20149(25.72)7(20.00)2(5.71)2(5.71)1(2.86)2(5.71)5(14.29)7(20.00)35
201514(26.42)7(13.21)3(5.66)4(7.55)1(1.89)5(9.43)8(15.09)11(20.75)53
201613(19.12)15(22.06)0(0.00)6(8.82)7(10.30)4(5.88)4(5.88)19(27.94)68
201715(25.43)17(28.81)2(3.39)3(5.08)3(5.08)5(8.48)4(6.78）10(16.95）59
201817(21.25)14(17.50)1(1.25)8(10.00)1(1.25)5(6.25)6(7.50)28(35.00）80
201922(22.37)21(19.44)3(2.78)10(9.26)2(1.85)6(5.56)13(12.04)31(28.70)108
202020(19.42)21(20.39)2(1.94)14(13.59)3(2.91)7(6.80)3(2.91)33(32.04)103
202119(16.52)23(20.00)4(3.48)8(6.96)3(2.61)7(6.09)14(12.17)37(32.17)115
202232(24.80)26(20.15)1(0.78)11(8.53)1(0.78)3(2.33)10(7.75)45(34.88)129
合计164(21.13)159(20.49)21(2.71)68(8.76)22(2.83)48(6.19)70(9.02)224(28.87)776
), ArticleFig(id=1241359975189107332, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=EN, label=Table 4, caption=

Distribution of causes of AIDS-related deaths in HIV/AIDS patients in Shandong Province, 2013—2022 [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年份艾滋病机会性感染艾滋病相关肿瘤艾滋病相关特指疾病和综合征其他原因合计
201313(48.15)5(18.52)5(18.52)4(14.81)27
201415(45.45)4(12.12)9(27.27)5(15.15)33
201519(40.43)6(12.76)16(34.04)6(12.77)47
201615(41.67)4(11.11)10(27.78)7(19.44)36
20179(26.47)8(23.53)11(32.35)6(17.65)34
201813(36.11)8(22.22)6(16.67)9(25.00)36
201915(25.42)11(18.65)13(22.03)20(33.90)59
202022(43.15)6(11.76)6(11.76)17(33.33)51
202114(29.79)9(19.15)13(27.66)11(23.40)47
202210(24.39)10(24.39)9(21.95)12(29.27)41
合计145(35.28)71(17.28)98(23.84)97(23.60)411
), ArticleFig(id=1241359975268799109, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=CN, label=表4, caption=

2013—2022年山东省HIV/AIDS患者中艾滋病相关死亡的死因分布[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年份艾滋病机会性感染艾滋病相关肿瘤艾滋病相关特指疾病和综合征其他原因合计
201313(48.15)5(18.52)5(18.52)4(14.81)27
201415(45.45)4(12.12)9(27.27)5(15.15)33
201519(40.43)6(12.76)16(34.04)6(12.77)47
201615(41.67)4(11.11)10(27.78)7(19.44)36
20179(26.47)8(23.53)11(32.35)6(17.65)34
201813(36.11)8(22.22)6(16.67)9(25.00)36
201915(25.42)11(18.65)13(22.03)20(33.90)59
202022(43.15)6(11.76)6(11.76)17(33.33)51
202114(29.79)9(19.15)13(27.66)11(23.40)47
202210(24.39)10(24.39)9(21.95)12(29.27)41
合计145(35.28)71(17.28)98(23.84)97(23.60)411
), ArticleFig(id=1241359975407211143, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=EN, label=Table 5, caption=

Unordered multicategorical logistic regression analysis of causes of death of HIV/AIDS patients in Shandong Province from 2013 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
变量艾滋病相关死亡非艾滋病相关死亡
βOR(95% CI)PβOR(95% CI)P
性别
女11
男0.091.09(0.78~1.53)0.6090.561.75(1.38~2.20)<0.001
确诊年龄(岁)0.021.02(1.01~1.03)<0.0010.051.05(1.04~1.05)<0.001
确诊到开始ART时间(d)
≤30
>300.561.74(1.41~2.16)<0.0010.742.10(1.79~2.46)<0.001
受教育程度
初中及以下11
高中或中专-0.060.94(0.73~1.21)0.623-0.180.83(0.68~1.02)0.074
大专及以上-0.820.44(0.31~0.63)<0.001-0.270.77(0.60~0.98)0.035
职业
固定职业a11
流动职业b-0.250.78(0.58~1.06)0.113-0.030.97(0.76~1.23)0.791
农民0.081.09(0.81~1.46)0.5710.471.60(1.28~2.01)<0.001
其他0.041.04(0.71~1.53)0.841-0.180.84(0.60~1.17)0.295
婚姻状况
未婚11
已婚有配偶-0.330.72(0.54~0.96)0.025-0.310.74(0.59~0.92)0.005
离异或丧偶-0.060.94(0.68~1.30)0.710-0.170.84(0.66~1.07)0.167
感染途径
同性传播11
异性传播0.181.20(0.94~1.52)0.1430.561.75(1.48~2.08)<0.001
其他0.141.15(0.66~2.00)0.6161.052.84(2.00~4.05)<0.001
WHO临床分期
Ⅰ11
Ⅱ0.661.93(1.38~2.70)<0.0010.121.12(0.87~1.45)0.373
Ⅲ0.962.61(1.87~3.63)<0.0010.571.77(1.38~2.28)<0.001
Ⅳ1.574.81(3.71~6.23)<0.0010.181.20(0.91~1.58)0.190
治疗方案
TDF/AZT+3TC+EFV11
TDF/AZT+3TC+NVP0.832.30(1.67~3.16)<0.0010.832.30(1.84~2.88)<0.001
TDF/AZT+3TC+克力芝0.471.60(1.20~2.13)0.0010.361.43(1.13~1.81)0.003
其他-0.650.52(0.37~0.75)<0.001-0.680.51(0.38~0.68)<0.001
基线CD4细胞水平(个/μl)
0~20011
>200~350-1.430.24(0.17~0.33)<0.001-0.710.49(0.40~0.60)<0.001
>350~500-1.540.21(0.15~0.30)<0.001-0.970.38(0.30~0.48)<0.001
>500-1.680.19(0.13~0.27)<0.001-0.890.41(0.33~0.51)<0.001
), ArticleFig(id=1241359975520457353, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241342457602961430, language=CN, label=表5, caption=

2013—2022年山东省HIV/AIDS患者死亡原因的无序多分类logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量艾滋病相关死亡非艾滋病相关死亡
βOR(95% CI)PβOR(95% CI)P
性别
女11
男0.091.09(0.78~1.53)0.6090.561.75(1.38~2.20)<0.001
确诊年龄(岁)0.021.02(1.01~1.03)<0.0010.051.05(1.04~1.05)<0.001
确诊到开始ART时间(d)
≤30
>300.561.74(1.41~2.16)<0.0010.742.10(1.79~2.46)<0.001
受教育程度
初中及以下11
高中或中专-0.060.94(0.73~1.21)0.623-0.180.83(0.68~1.02)0.074
大专及以上-0.820.44(0.31~0.63)<0.001-0.270.77(0.60~0.98)0.035
职业
固定职业a11
流动职业b-0.250.78(0.58~1.06)0.113-0.030.97(0.76~1.23)0.791
农民0.081.09(0.81~1.46)0.5710.471.60(1.28~2.01)<0.001
其他0.041.04(0.71~1.53)0.841-0.180.84(0.60~1.17)0.295
婚姻状况
未婚11
已婚有配偶-0.330.72(0.54~0.96)0.025-0.310.74(0.59~0.92)0.005
离异或丧偶-0.060.94(0.68~1.30)0.710-0.170.84(0.66~1.07)0.167
感染途径
同性传播11
异性传播0.181.20(0.94~1.52)0.1430.561.75(1.48~2.08)<0.001
其他0.141.15(0.66~2.00)0.6161.052.84(2.00~4.05)<0.001
WHO临床分期
Ⅰ11
Ⅱ0.661.93(1.38~2.70)<0.0010.121.12(0.87~1.45)0.373
Ⅲ0.962.61(1.87~3.63)<0.0010.571.77(1.38~2.28)<0.001
Ⅳ1.574.81(3.71~6.23)<0.0010.181.20(0.91~1.58)0.190
治疗方案
TDF/AZT+3TC+EFV11
TDF/AZT+3TC+NVP0.832.30(1.67~3.16)<0.0010.832.30(1.84~2.88)<0.001
TDF/AZT+3TC+克力芝0.471.60(1.20~2.13)0.0010.361.43(1.13~1.81)0.003
其他-0.650.52(0.37~0.75)<0.001-0.680.51(0.38~0.68)<0.001
基线CD4细胞水平(个/μl)
0~20011
>200~350-1.430.24(0.17~0.33)<0.001-0.710.49(0.40~0.60)<0.001
>350~500-1.540.21(0.15~0.30)<0.001-0.970.38(0.30~0.48)<0.001
>500-1.680.19(0.13~0.27)<0.001-0.890.41(0.33~0.51)<0.001
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2013—2022年山东省HIV/AIDS患者死亡趋势及影响因素分析
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宋怡宁 1, 2 , 李亚君 3, 4 , 孙秀彬 1, 2, 4 , 闫钰婕 1, 2 , 路真真 5 , 朱晓艳 3, 4 , 李玲 3, 4 , 王国永 3, 4 , 张娜 3, 4 , 刘云霞 1, 2, 4
现代预防医学 | 流行病与统计方法 2024,51(4): 589-594
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现代预防医学 | 流行病与统计方法 2024, 51(4): 589-594
2013—2022年山东省HIV/AIDS患者死亡趋势及影响因素分析
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宋怡宁1, 2, 李亚君3, 4, 孙秀彬1, 2, 4, 闫钰婕1, 2, 路真真5, 朱晓艳3, 4, 李玲3, 4, 王国永3, 4, 张娜3, 4 , 刘云霞1, 2, 4
作者信息
  • 1.山东大学齐鲁医学院公共卫生学院生物统计学系， 山东 济南 250012
  • 2. 山东大学健康医疗大数据研究院
  • 3. 山东省疾病预防控制中心
  • 4. 山东大学预防医学研究院
  • 5. 潍坊医学院

    • 宋怡宁（1999—），女，硕士在读，研究方向：艾滋病流行病学

通讯作者:

刘云霞，Email：；
张娜，Email：
Analyses on death trend and influencing factors of HIV/AIDS patients, Shandong, 2013-2022
Yi-ning SONG1, 2, Ya-jun LI3, 4, Xiu-bin SUN1, 2, 4, Yu-jie YAN1, 2, Zhen-zhen LU5, Xiao-yan ZHU3, 4, Ling LI3, 4, Guo-yong WANG3, 4, Na ZHANG3, 4 , Yun-xia LIU1, 2, 4
Affiliations
  • Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
出版时间: 2024-02-25 doi: 10.20043/j.cnki.MPM.202311326
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摘要
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目的

了解山东省2013—2022年艾滋病病毒感染者和艾滋病病人（HIV/AIDS）的死亡趋势，并探讨相关影响因素。

方法

以2013—2022年现住址为山东省的25 181例HIV/AIDS患者为研究对象，收集研究对象的人口学特征、抗病毒治疗以及死亡原因等信息，根据生存状况将患者分为存活、艾滋病相关死亡和非艾滋病相关死亡三组，采用Kruskal-Wallis检验、χ2检验等进行组间比较，Joinpoint回归模型进行病死率趋势变化分析，并应用无序多分类logistic回归模型对HIV/AIDS患者死亡及其影响因素进行分析。

结果

山东省2013—2022年共报告HIV /AIDS患者死亡病例1 187例，其中艾滋病相关死亡占34.63%，非艾滋病相关死亡占65.37%，病死率呈逐年下降趋势（APC分别为-13.58,-20.29和-9.67，均P<0.05）。无序多分类logistic回归分析结果显示：确诊到开始ART时间>30天、WHO临床分期为Ⅱ、Ⅲ和Ⅳ是HIV/AIDS患者发生艾滋病相关死亡的危险因素，OR (95% CI)值分别为1.74（1.41~2.16）、1.93(1.38~2.70)、2.61(1.87~3.63)和4.81(3.71~6.23)；确诊到开始ART时间>30天、男性、农民和异性传播是HIV/AIDS患者发生非艾滋病相关死亡的危险因素，OR (95% CI)值分别为2.10（1.79~2.46）、1.75(1.38~2.20)、1.60(1.28~2.01)和1.75(1.48~2.08)。

结论

2013—2022年山东省HIV/AIDS患者开始ART后病死率呈下降趋势，死亡年龄增加，发生非艾滋病相关死亡的病死率总体高于艾滋病相关死亡。艾滋病相关死亡和非艾滋病相关死亡的影响因素存在一定差异，应制定有针对性的干预措施。

HIV/AIDS  /  抗逆转录病毒治疗  /  死亡趋势  /  影响因素  /  Joinpoint回归
Objective

To investigate the death trend of HIV/AIDS patients in Shandong Province from 2013 to 2022, andto explore the related influencing factors.

Methods

A total of 25 181 HIV/AIDS patients living in Shandong Province from 2013 to 2022 were selected as the study objects, demographic characteristics, antiretroviral therapy and causes of death were collected. Study objects were divided into three groups: survival, AIDS-related death and non-AIDS-related death. Kruskal-Wallis test and χ2 test were conducted for inter group comparison, Joinpoint regression model was used to analyze the trend change of mortality, and unordered multicategorical logistic regression was used to analyze HIV/AIDS death and its influencing factors.

Results

From 2013 to 2022, a total of 1 187 HIV/AIDS patients deaths were reported in Shandong Province, among which AIDS-related deaths accounted for 34.63% and non-AIDS-related deaths accounted for 65.37%. The mortality rates showed a decreasing trend (APC was -13.58, -20.29, and -9.67, respectively, all P<0.05). Unordered multicategorical logistic regression analysis showed that the time from diagnosis to ART initiation greater than 30 days, WHO clinical stage Ⅱ, Ⅲ, and Ⅳ were the risk factors for AIDS-related death of HIV/AIDS patients, and the OR (95% CI) values were 1.74(1.41-2.16), 1.93(1.38-2.70), 2.61(1.87-3.63) and 4.81(3.71-6.23); the time from diagnosis to ART initiation greater than 30 days, male, farmer and heterosexual transmission were the risk factors for non-AIDS-related death of HIV/AIDS patients, with OR (95% CI) values of 2.10(1.79-2.46), 1.75(1.38-2.20), 1.60(1.28-2.01), and 1.75(1.48-2.08).

Conclusion

From 2013 to 2022, the case fatality rate of HIV/AIDS patients in Shandong Province has shown a downward trend after the start of ART, the age of death increased, and the case fatality rate of non-AIDS-related deaths is generally higher than that of AIDS-related deaths. There are differences in the influencing factors for AIDS-related and non-AIDS-related deaths, and targeted interventions should be developed.

HIV/AIDS  /  Antiretroviral therapy (ART)  /  Death trend  /  Influencing factor  /  Joinpoint regression
宋怡宁, 李亚君, 孙秀彬, 闫钰婕, 路真真, 朱晓艳, 李玲, 王国永, 张娜, 刘云霞. 2013—2022年山东省HIV/AIDS患者死亡趋势及影响因素分析. 现代预防医学, 2024 , 51 (4) : 589 -594 . DOI: 10.20043/j.cnki.MPM.202311326
Yi-ning SONG, Ya-jun LI, Xiu-bin SUN, Yu-jie YAN, Zhen-zhen LU, Xiao-yan ZHU, Ling LI, Guo-yong WANG, Na ZHANG, Yun-xia LIU. Analyses on death trend and influencing factors of HIV/AIDS patients, Shandong, 2013-2022[J]. Modern Preventive Medicine, 2024 , 51 (4) : 589 -594 . DOI: 10.20043/j.cnki.MPM.202311326
正文
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抗逆转录病毒治疗（antiretroviral therapy, ART）通过延缓疾病病程并延长艾滋病病毒感染者和艾滋病病人（HIV/AIDS）的寿命，显著改变了HIV大流行的进程，同时降低了HIV的传播率和病死率[1]。然而，由于长期服用ART药物、人口老龄化以及人类免疫缺陷病毒（human immunodeficiency virus, HIV）对人体免疫力的破坏等影响，HIV/AIDS患者的死因发生了一定变化[2-3]。研究发现，非艾滋病相关死亡的比例呈上升趋势[3]。及时、准确地掌握HIV/AIDS患者的死亡趋势及影响因素，可为相关政策的制定提供重要的数据支持[4-5]。因此，本研究以山东省2013—2022年间接受ART的HIV /AIDS患者为研究对象，探究其接受ART后的死亡情况及影响因素。
1　对象与方法
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1.1　数据来源
选取山东省艾滋病综合防治基本信息系统中2013—2022年间接受ART随访管理的HIV/AIDS患者的病例资料。纳入标准：①现住址为山东省；②开始ART年龄≥15周岁；③病例类型为“确诊病例”和“临床诊断病例”；④基线和随访信息完整。排除标准：①户籍为“外籍”和“港澳台”；②死因“不详”。所有患者均已签署知情同意书。本研究经山东省疾病预防控制中心伦理委员会审核通过（批准号为：2015-4）。
1.2　方法
1.2.1　资料收集
收集研究对象的性别、年龄、受教育程度、职业、婚姻状况、感染途径、WHO临床分期、治疗方案、基线CD4细胞水平、确诊时间、开始ART时间、死亡的具体时间、死因等信息。
1.2.2　死因分类
本研究将死因划分为艾滋病相关死亡和非艾滋病相关死亡。艾滋病相关死亡主要包括艾滋病机会性感染、艾滋病相关肿瘤及其他艾滋病相关特指疾病和综合征。非艾滋病相关死亡主要包括艾滋病相关肿瘤外的恶性肿瘤、呼吸系统疾病、内分泌营养代谢疾病、消化系统疾病、心血管疾病、丙型或乙型肝炎以及自杀和吸毒过量等。
1.3　统计学分析
采用R 4.2.1和EXCEL 2016进行数据整理与分析。计数资料采用频数和构成比（%）描述，无序资料组间比较采用χ2检验，有序资料组间比较采用Kruskal-Wallis检验；计量资料根据是否服从正态分布采用均数±标准差（）或中位数和四分位数[M(P25,P75）]描述，组间比较采用方差分析或Kruskal-Wallis检验；病死率的时间变化趋势分析采用Joinpoint Regression Program 5.0；采用无序多分类logistic回归进行死亡影响因素分析。正态性检验采用K-S检验，检验水准为0.10。上述其他分析检验水准均为0.05。
2　结果
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2.1　基本情况
2013—2022年共有25 181例HIV/AIDS患者接受ART随访管理，其中男性22 793例（90.52%）、女性2 388例（9.48%）。研究期间报告死亡例数1 187，其中艾滋病相关死亡411人（34.63%）、非艾滋病相关死亡776人（65.37%）。
存活、艾滋病相关死亡和非艾滋病相关死亡三组的性别、确诊年龄、确诊到开始ART时间、受教育程度、职业、婚姻状况、感染途径、WHO临床分期、治疗方案和基线CD4细胞水平均存在统计学差异，具体结果见表1。
2.2　死亡特征分布
2013—2022年艾滋病相关死亡者的年龄由2013年的43(31,50)岁增加至2022年的47(40,54)岁，病死率由2013年的1.46%下降至2022年的0.17%，死亡的主要原因是艾滋病机会性感染。非艾滋病相关死亡者的年龄由2013的45(39,56)岁增加至2022年的53(41,65)岁，病死率由2013年的1.40%下降至2022年的0.54%，死亡的主要原因是恶性肿瘤和心血管疾病。艾滋病相关死亡的(APC=-20.29）下降速度要高于非艾滋病相关死亡（APC=-9.67）。见表2、表3、表4和图1。
2.3　死亡原因分析
以HIV/AIDS患者的生存状况（0-存活；1-艾滋病相关死亡；2-非艾滋病相关死亡）为因变量（0-存活为对照），表1中组间比较有统计学差异的因素为自变量，进行无序多分类logistic回归分析。结果显示：确诊到开始ART时间>30天（OR=1.74，95% CI：1.41~2.16）、WHO临床分期为Ⅱ（OR=1.93，95% CI：1.38~2.70）、Ⅲ（OR=2.61，95% CI：1.87~3.63）和Ⅳ（OR=4.81，95% CI：3.71~6.23）的HIV/AIDS患者发生艾滋病相关死亡的风险高；确诊到开始ART时间>30天（OR=2.10，95% CI：1.79~2.46）、男性（OR=1.75，95% CI：1.38~2.20）、农民（OR=1.60，95% CI：1.28~2.01）和异性传播（OR=1.75，95% CI：1.48~2.08）的HIV/AIDS患者发生非艾滋病相关死亡的风险高。见表5。
3　讨论
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艾滋病至今无法治愈，最大限度抑制病毒复制、重建和维持机体免疫功能是治疗艾滋病最主要的方法[6-7]。随着治疗覆盖面的扩大，山东省ART标准从之前的CD4细胞水平<200个/μL，调整到2016年起实施的“发现即治疗”策略[8]，更多的HIV/AIDS患者得到了及时治疗，生存质量和寿命都有了显著提升，2013—2022年期间HIV/AIDS患者的病死率明显下降。HIV/AIDS患者死亡年龄逐年增加，表明ART能延长生存时间。
死因分析发现，山东省艾滋病相关死亡的病死率已明显低于非艾滋病相关死亡，与国内外的研究结果一致[9-12]。艾滋病相关死亡的主要死因是机会性感染。HIV病毒会破坏HIV/AIDS患者的的免疫系统，增加机会性感染的风险[13]。随着ART工作的规范开展，山东省目前大多数HIV/AIDS患者的死亡可归因于非艾滋病相关疾病，其中非艾滋病相关肿瘤以及心血管疾病成为非艾滋病相关死亡的主要死因，与Croxford等[14]研究结果一致。长期接受ART可能导致血管异常，从而增加HIV/AIDS患者患心血管疾病的风险[15-17]，提示在针对艾滋病采取措施的同时要考虑出现其他非艾滋病相关并发症的风险，做好HIV/AIDS患者的健康管理。
本研究结果显示，HIV/AIDS患者WHO临床分期越高，发生艾滋病相关死亡的风险越大。这与王静等[18]研究结果一致。病例晚发现会对个体的健康产生不良影响，破坏人体免疫系统，造成疾病进程的进一步发展，诱发各种AIDS期的临床症状以及合并症[19]。确诊到开始ART时间越长，HIV/AIDS患者发生艾滋病相关死亡的风险越大，故应贯彻早发现早治疗的原则，积极在HIV/AIDS患者以及高危人群中普及HIV检测，降低死亡风险。
本研究还发现，确诊到开始ART>30天、男性、农民、异性传播的HIV/AIDS患者发生非艾滋病相关死亡的风险相对较高。这可能与男性、农民的健康意识相对较弱、依从性较差有关。通过异性传播途径感染的HIV/AIDS患者死亡风险高于同性传播，这与何世娇等[20]研究结果一致，提示在HIV/AIDS患者的随访管理中要针对重点人群进一步加强非艾滋病相关疾病的筛查工作，采取早干预早治疗的措施，进一步降低HIV/AIDS患者的病死率。
综上所述，实施ART后，2013—2022年山东省HIV/AIDS患者病死率逐年下降，死亡年龄增加，发生非艾滋病相关死亡的病死率总体上高于艾滋病相关死亡，临床分期高、确诊到开始ART间隔时间长、男性、农民、异性传播等是其死亡相关影响因素，因此，应分别制定有针对性的适宜干预措施。
基金
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  • 山东省自然科学基金(ZR2014HQ038)
  • 山东省医药卫生科技发展计划(2019WS438)
文献
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2024年第51卷第4期
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doi: 10.20043/j.cnki.MPM.202311326
  • 接收时间：2023-11-16
  • 首发时间：2026-03-19
  • 出版时间：2024-02-25
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  • 收稿日期：2023-11-16
基金
山东省自然科学基金(ZR2014HQ038)
山东省医药卫生科技发展计划(2019WS438)
作者信息
    1.山东大学齐鲁医学院公共卫生学院生物统计学系， 山东 济南 250012
    2. 山东大学健康医疗大数据研究院
    3. 山东省疾病预防控制中心
    4. 山东大学预防医学研究院
    5. 潍坊医学院

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刘云霞，Email：；
张娜，Email：
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https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202311326
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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