Fiala M, Swartz J, Teklehaimanot S, Kermani V, Funnye A S, Sayre J W, Gornbein J A
Department of Medicine, UCLA School of Medicine, USA.
Lymphology. 1997 Sep;30(3):128-36.
In 60 patients followed from the onset of acquired immunodeficiency syndrome (AIDS) to death, survival was determined by Cox Proportional Hazards Analysis in relationship to seven variables: time-dependent CD4+ and CD8+ peripheral lymphocyte counts, zidovudine treatment, cytomegalovirus (CMV) retinitis, time from AIDS onset, calendar year of AIDS onset (cohort effect), and age. Two significant prognostic variables were identified: zidovudine therapy and either CD4+ or CD8+ counts (the latter could not be distinguished due to concomitant high correlation). Treatment with zidovudine reduced the death rate by 75% compared to no treatment. When included in a proportional hazards regression with all covariates except for the other T lymphocyte count, every increase in CD4+ count of 10 cells was equivalent to a decline in the mortality rate by 13% (p = 0.046), and every increase in CD8+ count of 10 cells lowered the mortality by 1.4% (p = 0.0031). Patients treated with zidovudine and without CMV retinitis showed the slowest decline of both CD4+ and CD8+ counts. Both CD4+ and CD8+ levels are useful predictors of survival in patients with AIDS.
在60例从获得性免疫缺陷综合征（AIDS）发病直至死亡的随访患者中，通过Cox比例风险分析确定了与七个变量相关的生存率：随时间变化的外周血CD4 +和CD8 +淋巴细胞计数、齐多夫定治疗、巨细胞病毒（CMV）视网膜炎、从AIDS发病起的时间、AIDS发病的日历年（队列效应）以及年龄。确定了两个显著的预后变量：齐多夫定治疗以及CD4 +或CD8 +计数（由于两者高度相关，后者无法区分）。与未治疗相比，齐多夫定治疗使死亡率降低了75%。当纳入除另一个T淋巴细胞计数外的所有协变量的比例风险回归模型时，CD4 +计数每增加10个细胞相当于死亡率下降13%（p = 0.046），CD8 +计数每增加10个细胞死亡率降低1.4%（p = 0.0031）。接受齐多夫定治疗且无CMV视网膜炎的患者，其CD4 +和CD8 +计数下降最慢。CD4 +和CD8 +水平都是AIDS患者生存的有用预测指标。
