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研究生: 張輔仁
Fu-Jen Chang
論文名稱: 時間相依共變數之雙重存活時間分析—台灣愛滋病病患存活時間與 CD4 / CD8 比值關係之案例研究
Bivariate survival with time dependent covariate - a case study on the relationship between AIDS patient''s survival and CD4 / CD8 ratio
指導教授: 曾議寬
Yi-kuan Tseng
口試委員:
學位類別: 碩士
Master
系所名稱: 理學院 - 統計研究所
Graduate Institute of Statistics
畢業學年度: 96
語文別: 中文
論文頁數: 32
中文關鍵詞: 愛滋病邊際模型脆弱模型
外文關鍵詞: AIDS, frailty model, marginal model
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  • 雞尾酒療法是目前治療愛滋病最有效的療法,衛生署自 1997 年 4 月開始提供病患雞尾酒療法之治療藥物,至今已逾十年之久。台灣關於雞尾酒療法對於愛滋病的影響使用數學模型來分析的例子仍很少見,因此本篇針對台灣愛滋病病患的資料,使用邊際模型 (marginal model) 及脆弱模型 (frailty model) 這兩種多維度存活分析的方法來分析這資料,以便探討使用雞尾酒療法對於 HIV 檢驗成陽性到愛滋病病發,及病發後到死亡這兩段時間療效之差異以及 CD4 / CD8 比值高低的影響。


    Highly Active Anti-Retroviral Therapy, or HAART, is highly beneficial to many HIV-infected individuals. The Department of Health in Taiwan has began to provide the treatment
    of HAART for the AIDS patients since April, 1997. However, so far in Taiwan, there are very few cases using mathematical models to analyse the efficacy of HAART to HIV patients. Conseqently, to investigate the problem, we use marginal model and frailty model, two methods of multivariate survival data analysis. We want to find the different effect of HAART in two time periods, HIV infection to onset of AIDS and onset of AIDS to death and the different effects of CD4 / CD8 ratio.

    中文摘要 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i 英文摘要 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii 致謝辭 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii 圖目錄 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v 表目錄 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi 一 緒論 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 二 統計方法 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.1 邊際模型(Marginal Model) . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.1.1 存活時間 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.1.2 AG Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2.1.3 PWP Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2.1.4 WLW Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 2.1.5 夾擠估計量(Sandwich Variance Estimators) . . . . . . . . . . . . 10 2.2 脆弱模型(Frailty Model) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2.2.1 Penalized Likelihood Approach . . . . . . . . . . . . . . . . . . . . 12 三 實例分析 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 3.1 Kaplan-Meier 估計量 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 3.2 邊際模型(Marginal Model) . . . . . . . . . . . . . . . . . . . . . . . . . . 15 3.3 脆弱模型(Frailty Model) . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 3.4 治療效果的比較 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 四 結論 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 參考文獻 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 附錄 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 附錄一:整理資料的程式 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 附錄二:模型和圖形的程式 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

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