抗结核药物不良反应影响因素及预防措施分析  

Analysis of influencing factors of anti-tuberculosis drug adverse and prevention measures

作　　者：陈威涛[1] 刘芳[1] 满世军 许玲[2] CHEN Wei-tao;LIU Fang;MAN Shi-jun;XU Ling(Gansu Provincial Center for Disease Control and Prevention,Lanzhou,Gansu 730020,China)

机构地区：[1]甘肃省疾病预防控制中心,兰州730000 [2]甘肃省武威市疾病预防控制中心,甘肃武威733000

出　　处：《疾病预防控制通报》2018年第5期1-5,共5页Bulletin of Disease Control & Prevention(China)

摘　　要：目的了解影响抗结核药物发生不良反应的因素,为预防发生不良反应提供科学依据。方法收集2015年1月—2016年5月符合纳入标准的1 415例初治肺结核病病人作为研究对象,分析影响抗结核药物不良反应发生的因素。结果 1 398例有效研究对象,药物不良反应发生率为45.9%;单因素分析显示,不良反应组与正常组病人在年龄(χ2=42.970)、民族(χ2=38.641)、肝病史(χ2=9.992)和药物过敏史(χ2=14.344)方面差异有统计学意义(P<0.05);多因素Logistic回归分析显示,药物不良反应组与正常组在年龄、民族、肝病史和药物过敏史方面与药物不良反应有关:与19岁及以下的病人相比,20~39岁、40~59岁和60岁及以上肺结核病病人发生抗结核药物不良反应危险的OR值和95%CI分别为1.208(0.958~1.497),1.359(1.015~1.748)和3.268(1.957~9.348);与汉族病人相比较,藏族、回族和其他民族病人发生药物不良反应危险的OR值及95%CI分别为0.419(0.297~0.654),0.399(0.315~0.716)和1.068(0.836~1.129);有肝病史的肺结核病病人发生药物不良反应危险的OR=2.641,95%CI为1.305~5.031,有药物过敏史的肺结核病病人发生抗结核药物不良反应危险的OR=1.789,95%CI为1.109~3.004。结论甘肃省抗结核药物不良反应发生率偏高;应严格遵循抗结核药物治疗原则,加强体医融合和非医疗健康干预,积极预防不良反应的发生。Objective To know the factors influencing the adverse reaction of anti-tuberculosis drug in Gansu province,and provide scientific basis for the prevention of adverse reaction. Methods There were 1 415 subjects with pulmonary tuberculosis enrolled as the inclusion criteria during January 2015 to May 2016, and the factors causing adverse drug reactions（ADR） of the anti-tuberculosis drugs in the initial treatment were analyzed. Results The incidence rate of adverse reactions was 45.9% among 1 398 effective subjects. There were statistical differences（P〈0.05） between ADR and normal groups in age（χ2=42.970）, nationality（χ2=38.641）, liver disease（χ2=9.992） and drug allergy history（χ2=14.344） under univariate analysis. There were relations between the groups of ADR and normal in age, nationality, liver disease and drug allergy history under multiple logistic analysis. Compared with the patients under 19 year-old, the result of the ADR occurrence with OR（95%CI） was 1.208（0.958-1.497） in the group of 20-39 year-old, 1.359（1.015-1.748） in the group of 40-59 year-old and 3.268（1.957-9.348） in the group over 60 year-old, respectively. Compared with the Han patients, the result of the ADR occurrence with OR（95% CI） was 0.419（0.297-0.654） in Tibetan patients, 0.399（0.315-0.716） in Hui patients and 1.068（0.836-1.129）in other ethnic patients, respectively. The OR（95% CI） was 2.641（1.305-5.031） and 1.789（1.109-3.004） in the patients with liver disease and drug allergy history, respectively. Conclusions The incidence rate of ADRs of anti-tuberculosis drugs is high in Gansu province. The principle of the treatment must be strictly followed. The combination of sport and medicine and the non medical intervention should be strengthened for ADRs prevention.

关 键 词：结核病 抗结核药物 不良反应 预防措施 

分 类 号：R521[医药卫生—内科学]