贵州省肺结核患者治疗依从性评分量表应用效果分析  

Analysis on application effect of scale score of treatment compliance of pulmonary tuberculosis patients in Guizhou province

作　　者：陈玮[1,2] 雷世光[2] 李杨[2] 宋群峰[2] 安竹[2] 余浪[3] 陈静[4] 李亚斐[1] 

机构地区：[1]第三军医大学预防医学院流行病学教研室,重庆400038 [2]贵州省疾病预防控制中心,贵阳550001 [3]重庆市中山医院病案室,400013 [4]贵州省贵阳市肺科医院结核科,550004

出　　处：《重庆医学》2015年第6期816-818,共3页Chongqing medicine

基　　金：贵州省卫生计生委科研基金课题(gzwkj2013-1-080)

摘　　要：目的验证ARS量表的准确性。方法采取队列研究的方法在10个县（市）引入ARS量表,对2013年11月至2014年5月6个月中登记治疗的患者进行评分,设定评分〈4分的为依从组,≥4分的为不依从组,随访观察患者治疗2个月末复查、取药依从性。结果依从组和不依从组中年龄、性别、民族和是否是流动人口差异无统计学意义（P〉0.05）,初复治情况有统计学意义（P〈0.05）。1 824例患者平均评分为（3.40±1.40）分,其中依从组平均评分为（2.34±0.73）分,不依从组平均评分为（4.69±0.81）分。评分主要集中在2~5分的占86%。ARS评分判断分组与2个月末复查结果吻合度检验,Kappa系数为0.403（P〈0.05）。灵敏度为71.1%,特异度为70.2%,正确指数为0.41。ARS评分、初复治情况与患者复查依从性的多元Logistic回归分析结果显示,ARS评分相同的情况下,复治患者复查依从性较初治患者差（OR=0.41,P〈0.05）;在初复治情况相同的前提下,ARS评分小于4分者的复查依从性是大于等于4分者的5.65倍（P〈0.05）。结论 ARS量表能较准确地判断患者依从性,有较高的灵敏度和特异度,适合在贵州省应用,但推广时要考虑其他干扰因素。Objective To verify the accuracy of ARS scale.Methods A cohort study was conducted in 10counties（city）the introduction of the ARS scale from 2013 November to 2014 May（6months）,the registrations were undertake score,and score 4were compliance group,more than 4cent were nonadherence group.Follow-up observation include review at the end of 2nd month after treatment and medicine compliance.Results There was no significant difference in age,gender,nationality and whether the floating population between the compliance group and non compliance group（P〉0.05）,initial treatment and retreatment was statistically significant（P〈0.05）.1 824 patients had a mean score of 3.40±1.40,including compliance group mean score was 2.34±0.73,is not in compliance with group mean score was 4.69±0.81.Mainly concentrated in the 2-5scores accounted for 86%.The ARS score of 2at the end of the packet and judge review the results of test,the Kappa coefficient was 0.403（P〈0.05）.The sensitivity was 71.1%,specificity was 70.2%,the correct index 0.41.Multivariate Logistic and review the compliance of patients re treatment ARS score,at the beginning of the results of regression analysis showed that ARS score,under the same conditions,retreatment review compliance was initially treated patients with difference（OR=0.41,P〈0.05）;in the initial treatment and retreatment premise under the same circumstances,review of compliance with the ARS score less than 4points.It′s 5.65 times greater than or equal to 4points（P〈0.05）.Conclusion The ARS scale can accurately judge the patient compliance,with high sensitivity and specificity,suitable for application in Guizhou Province,but we should consider other interference factors of promotion.

关 键 词：结核 预防和控制 依从性 贵州省 

分 类 号：R521[医药卫生—内科学]