摘要
目的 了解杭州市耐多药肺结核(multidrug-resistant pulmonary tuberculosis, MDR-PTB)患者的治疗转归情况,分析其影响因素。方法 采用整群抽样方法抽取2016—2020年符合纳入标准的研究对象,通过国家结核病信息管理系统,收集研究对象的人口学和诊疗信息,采用Cox比例风险回归模型分析研究对象治疗转归的影响因素。结果 共纳入306例研究对象,平均治疗时间(630.58±191.62)天,治疗成功率81.1%。2016—2020年开始治疗的研究对象治疗成功率分别为79.5%、70.9%、74.2%、88.5%和92.7%,经趋势性χ^(2)检验,差异有统计学意义(P<0.01)。最终纳入Cox比例风险回归模型并有统计学差异的变量为:开始治疗时间为2019年(HR=1.52,95%CI=1.04~2.22,P=0.0291),开始治疗时间为2020年(HR=3.45,95%CI=2.35~5.06,P<0.0001),年龄<37岁(HR=1.63,95%CI=1.25~2.11,P=0.0003)。结论 杭州市的MDR-PTB治疗水平逐年提高,需重点加强对中老年患者的诊治和督导管理。
Objective To study the treatment outcome of patients with multidrug-resistant pulmonary tuberculosis(MDR-PTB)in Hangzhou City and to analyze the factors that influence these outcomes.Methods A cluster sampling method was conducted to enroll participants who met the inclusion criteria from the years 2016 to 2020.Sociodemographic and clinical characteristic information was downloaded from the national tuberculosis information system.The Bivariate and multivariable Cox proportional hazards regression analyses were used to identify related risk factors of treatment outcome.Results A total of 306 MDR patents were enrolled,with an average treatment duration of(630.58±191.62)d and a treatment success rate of 81.1%.The treatment success rates for study subjects who started treatment in the years 2016 to 2020 were 79.5%,70.9%,74.2%,88.5%,and 92.7%,respectively.The trendχ^(2) test showed significant difference(P<0.01).The variables that were ultimately included in the Cox proportional hazards regression model and showed statistical differences were:starting treatment in 2019(HR=1.52,95%CI=1.04~2.22,P=0.0291),starting treatment in 2020(HR=3.45,95%CI=2.35~5.06,P<0.0001),and age<37 years(HR=1.63,95%CI=1.25~2.11,P=0.0003).Conclusions The treatment efficacy of MDR-PTB in Hangzhou City has exhibited a gradual improvement over the years.It is necessary to focus on strengthening the diagnosis,treatment,and supervision management of middle-aged and elderly patients.
作者
吴亦斐
陈珺芳
谢立
陆敏
程庆林
黄银燕
贾庆军
李清春
WU Yifei;CHEN Junfang;XIE Li;LU Min;CHENG Qinglin;HUANG Yinyan;JIA Qingjun;LI Qingchun(Institute for Tuberculosis Control and Prevention,Hangzhou Center for Diseases Control and Prevention(Hangzhou Health Supervision Institution),Hangzhou 310021,China)
出处
《健康研究》
CAS
2024年第3期241-245,共5页
Health Research
基金
浙江省基础公益研究计划项目(LGF21H190002)
浙江省医药卫生科技计划项目(2020KY238,2021KY951)
杭州市卫生科技计划项目(A20200280,A20220558)
杭州市医药卫生科技项目市科技局引导项目(20220919Y060)
关键词
耐多药
肺结核
治疗转归
危险因素
multidrug-resistant
pulmonary tuberculosis
treatment outcome
risk factors
