王硕, 何梦雅, 张艳秋, 李栋梁, 谢春雨, 孟澜涛, 孙定勇. 河南省1 165例耐多药和广泛耐药肺结核患者治疗结局及影响因素分析[J]. 凯发娱乐加盟代理. DOI: 10.3784/jbjc.202303170106
引用本文: 王硕, 何梦雅, 张艳秋, 李栋梁, 谢春雨, 孟澜涛, 孙定勇. 河南省1 165例耐多药和广泛耐药肺结核患者治疗结局及影响因素分析[J]. 凯发娱乐加盟代理. DOI: 10.3784/jbjc.202303170106
Wang Shuo, He Mengya, Zhang Yanqiu, Li Dongliang, Xie Chunyu, Meng Lantao, Sun Dingyong. Treatment outcomes of 1165 patients with multidrug-resistant and extensively drug-resistant pulmonary tuberculosis and influencing factors[J]. Disease Surveillance. DOI: 10.3784/jbjc.202303170106
Citation: Wang Shuo, He Mengya, Zhang Yanqiu, Li Dongliang, Xie Chunyu, Meng Lantao, Sun Dingyong. Treatment outcomes of 1165 patients with multidrug-resistant and extensively drug-resistant pulmonary tuberculosis and influencing factors[J]. Disease Surveillance. DOI: 10.3784/jbjc.202303170106

河南省1 165例耐多药和广泛耐药肺结核患者治疗结局及影响因素分析

Treatment outcomes of 1165 patients with multidrug-resistant and extensively drug-resistant pulmonary tuberculosis and influencing factors

  • 摘要:
      目的   掌握耐多药结核的治疗结局并探讨其影响因素。
      方法   2022年通过问卷调查,收集1 165例河南省结核病报告系统中登记报告的耐多药肺结核患者治疗、转归等相关信息进行回顾性分析。 采用SPSS 27.0软件对收集的治疗、转归结果进行流行病学描述,采用单因素与多因素logistic分析的方法分析治疗结局的影响因素。
      结果   1 165例耐药结核病患者中,良性结局(成功治疗)的患者占54.7%;多因素logistic回归分析结果显示,年龄≥65岁组的患者发生不良结局的风险是年龄≤25岁组的2.380倍[比值比(OR)=0.390,95%置信区间(CI):1.220~4.643],体质指数(BMI)≥24.0 kg/m2的患者发生不良结局的风险是BMI≤18.4 kg/m2的39.0%(OR=0.390,95%CI:0.182~0.834),复治患者发生不良结局的风险是新患者的1.149倍(OR=1.149,95%CI:1.026~1.287),无规律运动的患者发生不良结局的风险是有规律运动患者的1.709倍(OR=1.709,95%CI:1.128~2.589),耐多药治疗期间存在14 d以上中断治疗的患者发生不良结局的风险是无中断治疗患者的3.762 倍(OR=3.762,95%CI:2.100~6.739)。
      结论   河南省耐多药肺结核患者治疗成功率在我国属中等水平,但患者数量多,需要重点关注高年龄段、复治患者、营养状况不佳的患者,同时提倡规律运动,提高患者治疗依从性,从而增加患者治疗成功率。

     

    Abstract:
      Objective  To understand the treatment outcome of multidrug-resistant tuberculosis (TB) and analyze the influencing factors.
      Methods  Information related to treatments and outcomes of 1 165 patients with multidrug-resistant TB registered and reported in the Tuberculosis Reporting System of Henan Province were collected through a questionnaire survey in 2022 for a retrospective analysis. Software SPSS 27.0 was used for the descriptive epidemiological analysis, and the influencing factors for treatment outcome were analyzed by univariate and multivariate analyses.
      Results  Of the 1165 patients with multidrug-resistant TB, 54.7% had benign outcomes (successful treatment). Multivariate logistic regression analysis showed that the risk for adverse outcome was 2.380 times higher in age group ≥65 years than in age group ≤25 years odds ratio (OR)=0.390, 95% confidence interval (CI): 1.220?4.643, the risk for adverse outcome in patients with body mass index (BMI) ≥24.0 kg/m2 was 39.0% higher than that in those with a BMI ≤18.4 kg/m2 (OR=0.390, 95%CI: 0.182 to 0.834), the risk for adverse outcomes was 1.149 times higher in patients with repeated treatment than that in newly detected patients (OR=1.149, 95%CI: 1.026 to 1.287), the risk for adverse outcome was 1.709 times higher in patients without regular exercise than in patients with regular exercise (OR=1.709, 95%CI: 1.128 to 2.589), and the risk for adverse outcome was 3.762 times higher in patients with more than 14 days of treatment interruption for multidrug-resistant therapy than in patients without treatment interruption (OR=3.762, 95%CI: 2.100 to 6.739).
      Conclusion  The treatment success rate of multidrug-resistant TB patients in Henan was moderate in China, but the number of patients was high. It is necessary to pay attention to the patients with older age, retreatment and poor nutritional status, promote regular exercise and improve patient compliance with treatment to increase the success rate of TB treatment.

     

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