115例初治涂阳肺结核患者抗结核药物不良反应发生率和影响因素研究  

Study on the incidence and risk factors of adverse reactions of anti- tuberculosis drugs in 115 new smear positive pulmonary tuberculosis patients

作　　者：熊姿[1,2] 白丽琼 王孝君[2] 龚德华 李清香 彭瑶 潘林[4] 

机构地区：[1]中南大学公共卫生学院流行病与卫生统计学教研室,湖南长沙410078 [2]长沙市疾病预防控制中心 [3]湖南省结核病防治所 [4]宁乡县疾病预防控制中心

出　　处：《实用预防医学》2015年第5期537-540,共4页Practical Preventive Medicine

基　　金：湖南省科技厅科研基金(2013SK3225);湖南省卫生厅科研基金(B2013-115)

摘　　要：目的探索初治涂阳患者接受抗结核治疗的不良反应发生率及影响因素。方法在知情同意下,以2013年10-12月到长沙市岳麓区和宁乡县接受固定复合制剂（FDC）治疗的115例初治涂阳患者为研究对象,监测其疗程中药物不良反应发生情况,采用单因素和多因素分析方法,研究其抗结核病药物发生的影响因素。结果 115例患者中发生不良反应的共43例,不良反应发生率为37.4%。单因素分析显示：不同年龄（Waldχ2=6.436,P=0.040）、文化程度（Waldχ2=8.776,P=0.032）、体重指数（Waldχ2=6.534,P=0.038）、饮酒史（Waldχ2=4.019,P=0.045）的患者不良反应情况差异均有统计学意义;对单因素分析后有统计学意义的变量进行多因素非条件Logistic回归分析,结果显示：年龄偏大（Waldχ2=14.337,P=0.001）、文化程度低（Waldχ2=16.042,P=0.001）、饮酒史（Waldχ2=8.392,P=0.004,95%CI：1.638～12.912）是抗结核药物不良反应危险因素。结论该115例初治涂阳肺结核患者抗结核药物不良反应发生率较高,患者年龄大、文化程度低、有饮酒史可增加抗结核药物不良反应的发生率。Objective To explore the incidence and risk factors of adverse reactions of anti- tuberculosis（ anti- TB） drugs in new smear positive pulmonary tuberculosis patients. Methods Totally,115 new smear positive pulmonary tuberculosis patients who received fixed- dose combination（ FDC） treatment in Yuelu District,Changsha and Ningxiang County from October to December 2013 were recruited. The incidence of adverse reactions of anti- TB drugs that occurred in the course of treatment was monitored. Risk factors of adverse reactions were explored by univariate and multivariate analysis. Results Adverse reactions occurred in 43 out of 115 cases,with an incidence rate of 37. 4%. The univariate analysis showed that the incidence of adverse reactions was significantly different among groups by age（ Wald χ2= 6. 436,P = 0. 040）,education level（ Wald χ2= 8. 776,P = 0.032）,body mass index（ Wald χ2= 6. 534,P = 0. 038）,and drinking history（ Wald χ2= 4. 019,P = 0. 045）. Multivariate non-conditioned logistic regression analysis indicated that advanced age（ Wald χ2= 14. 337,P = 0. 001）,lower education level（ Waldχ2= 16. 042,P = 0. 001） and drinking history（ Wald χ2= 8. 392,P = 0. 004） were risk factors. Conclusions The incidence of adverse reactions of anti- tuberculosis drugs in the 115 new smear positive pulmonary tuberculosis patients is high. Advanced age,lower education level and drinking history can increase the incidence.

关 键 词：肺结核 抗结核药物 不良反应 危险因素 

分 类 号：R521[医药卫生—内科学]