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作 者:吕德良[1] 杨应周[1] 谭卫国[1] 张乐平[1] 朱赛楠[2] 李蓉安 车晓玲[1]
机构地区:[1]深圳市慢性病防治中心,广东深圳518020 [2]北京大学第一医院医学统计室,北京100034
出 处:《中国热带医学》2016年第7期649-652,665,共5页China Tropical Medicine
基 金:"十二五"国家科技重大专项(No.2012ZX10004903);深圳市科技项目(No.201302154)
摘 要:目的掌握深圳市耐多药结核病(multi-drug resistant tuberculosis,MDR-TB)治疗转归情况,分析治疗未成功的主要原因,为进一步完善深圳市耐多药结核病防控措施提供科学依据。方法以2006年10月—2013年10月期间确诊的MDR-TB患者为研究对象,患者治疗前经专家组评估后,实施个体化治疗和全程督导服药管理。患者治疗转归由专家组根据判定标准讨论确定。对患者治疗转归情况和治疗未成功的原因进行描述性分析和单因素分析。结果纳入项目治疗的MDR-TB患者165例,治愈99例(60.0%),完成治疗10例(6.1%),治疗未成功56例(33.9%),治疗成功率为66.1%。治疗未成功的主要原因是因药物不良反应和患者主观因素(丢失、拒治、拒绝复查、迁出、自杀死亡)导致的停止继续治疗,分别占到25.0%(14/56)和62.5%(35/56)。结论药物不良反应和患者主观因素是导致深圳市MDR-TB患者治疗未成功的主要原因,应针对性制定和实施相应的防治措施,可取得更好的治疗效果。Objective To master the treatment outcomes of multi-drug resistant tuberculosis(MDR-TB)and find out the main unsuccessful reasons and prevention measures,so as to provide the evidence for further improving the prevention and control measures of MDR-TB in Shenzhen City. Methods The MDR-TB patients diagnosed from October 2006 to October2013 were selected as the research objects. The patients who were assessed by the expert group before the treatment received the whole course directly-observed supervision and individual therapy. The treatment outcomes were determined by the expert group according to the criteria of decision. At the end,the treatment outcomes of the patients and unsuccessfully reasons of the treatment were analyzed by the descriptive analysis and single factor analysis methods. Results Among 165 MDR- TB patients treated in the project,99 patients were cured(60.0%),10 patients completed the treatment(6.1%),56 patients failed(33.9%),and the treatment success rate was 66.1%. The main unsuccessful reasons were the adverse drug reactions and the subjective factors of the patients(lost,refused further treatment or examination,moved out,suicide),accounted for 25.0%(14/56)and 62.5%(35/56),respectively. Conclusion Adverse drug reactions and subjective factors are the main reasons of unsuccessful treatment in the MDR- TB patients in Shenzhen. Therefore,to develop and implement appropriate control measures for them can achieve the better therapeutic effect.
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