目的：探讨人类免疫缺陷病毒（HIV）感染/艾滋病（AIDS）住院患者高效抗逆转录病毒治疗（HAART）中发生骨髓抑制致

死亡的影响因素。方法：采用病例对照研究的方法，调查2011 年1 月—2015 年7 月南宁市第四人民医院的735 例住院HIV 感染/

AIDS住院患者，通过单因素和多因素非条件Logistic 分析筛选出导致患者死亡的危险因素。结果：735 例患者中，生存组648 例，

死亡组87 例，病死率为11.8％。单因素Logistic 分析显示：男性、老年、总胆红素升高、内生肌酐清除率降低、基线CD4+ T淋巴细

胞数较低、合并机会性感染较多、联合多种具有骨髓抑制的药物、血小板减少、血红蛋白减少是HAART中死亡的危险因素，而患

者HIV感染途径、有齐多夫定的HAART方案、开始HAART时患者的体质量是HAART中死亡的保护性因素；多因素Logistic 回归

分析显示：男性、老年、总胆红素升高、内生肌酐清除率降低、基线CD4+ T淋巴细胞数较低、合并机会性感染较多、联合多种具有骨

髓抑制的药物、血小板减少、血红蛋白减少是死亡的危险因素。结论：临床应针对住院HIV感染者/AIDS患者HAART中发生骨髓

抑制致死亡的危险因素，采取有针对性的治疗和控制措施，以降低患者病死率。

OBJECTIVE：To explore risk factors for the death in HIV/AIDS patients suffering from myelosuppression during

highly active antiretroviral therapy（HAART）treatment. METHODS：The historical cohort study method was used to choose 735 inpatients

from Nanning Forth People’s Hospital during Jan. 2011 to Jul. 2015. Univariate and multivariate Logistic regression analysis

were used to show the risk factors for the death. RESULTS：Of 735 cases，there were 648 survival cases and 87 dead cases，

with mortality of 11.8％. Univariate Logistic analysis showed that：male，elder，higher total bilirubin，lower creatinine clearance，

lower CD4+T cell count in baseline，combined more opportunistic infection，combined more myelosuppressive drugs，thrombocytopenia，

lower hemoglobin were the risk factors for the death of HIV patients with myelosuppression in HARRT treatment，while

route of HIV infection，HAART treatment A including Zidovudine，weight were the protective factors. Multivariate Logistic regression

analysis showed male，elder，higher total bilirubin，lower creatinine clearance，lower CD4+ T cell count in baseline，combined

more opportunistic infection，combined more myelosuppressive drugs，thrombocytopenia，lower hemoglobin were the risk

factors for the death of HIV patients with myelosuppression in HARRT treatment too. CONCLUSIONS：Pertinence treatment and

control methods for HIV/AIDS with myelosuppression in HARRT treatment should be taken to reduce the mortality in the future．