Friedland G H, Saltzman B, Vileno J, Freeman K, Schrager L K, Klein R S
Department of Medicine, Montefiore Medical Center, Bronx, New York 10467.
J Acquir Immune Defic Syndr (1988). 1991;4(2):144-53.
To define the clinical, demographic, and behavioral variables that may influence survival in patients with AIDS, we studied 526 patients with AIDS diagnosed through September 1987 who were cared for at a single medical center. A diversity of racial and ethnic backgrounds, ages, both men and women, and all risk behaviors except hemophilia were well represented. The initial AIDS defining diagnosis was the most powerful predictor of survival. The median survival was 12.8 months for patients presenting with Kaposi's sarcoma (p less than 0.001), 10.9 months for patients presenting with Pneumocystis carinii pneumonia (p less than 0.001), and 4.8 months for patients presenting with other infections or neoplasms (p less than 0.02). For the entire series, male sex and younger age were associated with more favorable survival (p less than 0.025). For those presenting with Pneumocystis carinii pneumonia, in addition to younger age (p less than 0.025), black race (p less than 0.025) and the combination of male sex and intravenous drug use (p less than 0.005) were associated with a more favorable survival. Within a setting of comparable clinical care, survival from the point of diagnosis of AIDS is associated most strongly with the initial AIDS diagnosis, but differences in age, gender, race, and risk behavior also exert an influence on survival.
为确定可能影响艾滋病患者生存的临床、人口统计学及行为学变量，我们研究了1987年9月前在单一医疗中心接受治疗的526例经诊断患有艾滋病的患者。研究涵盖了各种种族和族裔背景、不同年龄、男女患者，且除血友病外的所有风险行为类型均有充分代表。最初的艾滋病确诊诊断是生存的最强有力预测因素。患有卡波西肉瘤的患者中位生存期为12.8个月（p<0.001），患有卡氏肺孢子虫肺炎的患者为10.9个月（p<0.001），患有其他感染或肿瘤的患者为4.8个月（p<0.02）。在整个研究系列中，男性和较年轻患者的生存情况更有利（p<0.025）。对于患有卡氏肺孢子虫肺炎的患者，除了较年轻（p<0.025）外，黑人种族（p<0.025）以及男性与静脉吸毒的组合（p<0.005）与更有利的生存相关。在可比的临床护理环境中，从艾滋病诊断时起的生存情况与最初的艾滋病诊断关联最为紧密，但年龄、性别、种族和风险行为的差异也会对生存产生影响。
