1749例肺结核患者治疗依从性特点及影响因素分析  

Treatment Adherence Characteristics and Influencing Factors of Patients with Tuberculosis

作　　者：陈玮[1,2] 雷世光[2] 李杨[2] 宋群锋[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,贵州贵阳550001 [3]重庆市中山医院,重庆400013 [4]贵阳市肺科医院,贵州贵阳550004

出　　处：《现代预防医学》2016年第2期346-349,共4页Modern Preventive Medicine

基　　金：贵州省卫生计生委科研基金课题(gzwkj2013-1-080);第三军医大学MPH研究生课题

摘　　要：目的分析贵州省肺结核患者治疗依从性特点及相关影响因素，为下一步制定提高患者治疗依从性措施提供依据。方法随机抽取10个县2013年11月1日-2014年5月31日期间治疗的1749例肺结核患者，收集患者的基本信息和治疗2月末、5月末和6（8）月末复查、取药延迟情况进行统计分析。结果1749例患者治疗2月末、5月末、6（8）月末中曾出现过至少1次不依从1001例，占57．2％（1001／1749），出现过2次不依从300例，占17．2％（300／1749），出现过3次不依从89例，占5．1％（89／1749）。1001例不依从患者中，延迟2～9d的占一半左右。经单因素统计分析，涂阳和涂阴患者、初治和复治患者总体依从情况差异有统计学意义，P〈0．05。经多因素Logistic回归分析，患者诊断结果、初复治情况同时为患者治疗总体依从性的影响因素，P〈0．05。涂阳患者总体依从性较涂阴患者好，初治患者总体依从性较复治患者好。结论贵州省肺结核患者治疗依从性特点为出现不依从比例大，延时时间主要集中在2—9d，疗程结束时出现不依从比例高，诊断结果和初复治情况是患者依从性的影响因素。Objective This work was to analyze the treatment adherence characteristics and related influencing factors of patients with tuberculosis, and provide references for the improvement of treatment adherence. Methods A total of 1749 patients with tuberculosis from November 1, 2013 to May 31, 2014 in ten counties were randomly selected. Analysis was conducted based on the basic information and the late second, fifth, and sixth （eighth） month review and medicine delay of the patients. Results Among the 1749 patients, 1001 had non-adherence at least once in second, fifth, and sixth （eighth） month, accounting for 57.2% （1001/1749）; 300 non-adherence twice, accounting for 17.2% （300/1749）; 89 non-adherence three times, accounting 5.1% （89/1749）. Among the 1001 non-adherence patients, a half had 2-9 days delay. Based on single factor analysis, significant differences were observed between smear-positive and smear-negative patients, initial treatment and re-treatment patients （P〈0.05）. Based on muhivariable logistic regression analysis, the initial diagnosis result and retreatment condition of patients were influencing factors of the overall adherence （P〈0.05）. The overall adherence of smear-positive patients was better than smear-negative patients. Initial treatment patients were better than re-treatment patients. Conclusion TB treatment of Guizhou Province features with high non-adherence ratio, 2-9 days delay, and high non-adherence ratio after treatment. The sputum bacteria and initial situation are the influencing factors of patient adherence.

关 键 词：结核 依从性 特点 贵州省 

分 类 号：R195[医药卫生—卫生统计学]