新疆维吾尔族人群肺结核治疗结局影响因素研究  

Factors Affecting Treatment Outcomes of Pulmonary Tuberculosis in Xinjiang Uygur Population

作　　者：杨丹[1] 文进[2] 刘年强[3] 阿依努尔.莫合买提 齐曼古力.吾守尔 胡昕[1] 郝艳艳[1] 王晶[1] YANG Dan;WEN Jin;LIU Nianqiang;AYINUER·Mohemaiti;QIMANGULI·Wushouer;HU Xin;HAO Yanyan;WANG Jing(No.1 Department of Respiratory,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;No.2 Department of Critical Care Medicine,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Tuberculosis Prevention and Control Center,Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院呼吸一科,新疆乌鲁木齐市830000 [2]新疆医科大学第二附属医院重症医学二科,新疆乌鲁木齐市830000 [3]新疆维吾尔自治区疾病预防控制中心,新疆乌鲁木齐市830000

出　　处：《中国全科医学》2019年第12期1413-1418,共6页Chinese General Practice

基　　金：新疆维吾尔自治区重大科技专项(2017A03006-2);新疆重大疾病医学重点实验室开放课题(SKLIBXJMDR-2016-4);省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2017-Y12)

摘　　要：背景结核病是由结核分枝杆菌感染引起的一种慢性传染病,是全球主要的公共卫生问题之一。且据中国疾病预防控制中心分析显示,2015年新疆肺结核报告发病率位居全国第一。目的分析新疆维吾尔族人群肺结核治疗结局的影响因素,为新疆肺结核防治工作提供理论依据。方法 2016年3—4月,选取2014年7月—2015年6月在全国结核病网络专报系统中登记的新疆维吾尔族肺结核患者。回顾性收集研究对象的一般人口学资料(年龄、性别、居住地、户籍地、职业)和临床资料(患者来源、痰涂片结果、诊断类型、治疗类型、治疗结局),并分析肺结核患者治疗结局的影响因素。结果 2014年7月—2015年6月在全国结核病网络专报系统中共登记24 298例新疆维吾尔族肺结核患者,其中29例诊断变更,889例无治疗结局,最终纳入研究23 380例。23 380例新疆维吾尔族肺结核患者中,治疗不成功1 490例(6.4%),死亡564例(2.4%)。多因素Logistic回归分析结果显示,年龄〔≥60岁:OR=1.550,95%CI(1.386,1.733)〕、居住地〔乡村:OR=1.241,95%CI(1.065,1.446)〕、职业〔专业技术人员及干部职员:OR=2.031,95%CI(1.038,3.974);离退休人员:OR=2.050,95%CI(1.073,3.915)〕、患者来源〔转诊:OR=1.812,95%CI(1.190,2.758);追踪:OR=1.624,95%CI(1.047,2.517)〕、痰涂片结果〔涂阳:OR=1.622,95%CI(1.420,1.854)〕、治疗类型〔复治:OR=1.859,95%CI(1.545,2.237)〕是患者治疗不成功的影响因素(P<0.05)。年龄〔≥60岁:OR=2.462,95%CI(2.038,2.975)〕、性别〔男:OR=1.394,95%CI(1.174,1.656)〕、居住地〔乡村:OR=1.265,95%CI(1.002,1.598)〕、痰涂片结果〔涂阳:OR=2.027,95%CI(1.652,2.486)〕、治疗类型〔复治:OR=1.606,95%CI(1.216,2.121)〕是患者死亡的影响因素(P<0.05)。结论年龄、居住地、职业、患者来源、痰涂片结果、治疗类型是患者治疗不成功的影响因素,年龄、性别、居住地、痰涂片结果、治疗类型是患者死亡的Background Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis infection,which is one of the major public health problems in the world.According to the analysis of Chinese Center for Disease Control and Prevention,the reported incidence of tuberculosis in Xinjiang ranked first in China in 2015.Objective To analyze the factors affecting treatment outcomes of pulmonary tuberculosis in Xinjiang Uygur Population,providing a theoretical basis for the prevention and treatment of pulmonary tuberculosis in Xinjiang.Methods From March to April 2016,Uygur tuberculosis patients in Xinjiang registered in the National Tuberculosis Network Special Reporting System from July 2014 to June 2015 were selected.General demographic data (age,gender,place of residence,hukou location,occupation) and clinical data (patient source,sputum smear results,type of tuberculosis,type of treatment,treatment outcomes) of the patients were collected retrospectively,and the factors affecting treatment outcomes were analyzed.Results Of the 24 298 cases registered, 29 had a diagnosis change,889 had no reported treatment outcomes,the remaining 23 380 were eventually included in the study. Among the 23 380 cases,1 490 (6.4%) had failed treatment,and 564 died(2.4%) from tuberculosis.Multivariate Logistic regression analysis showed that age ≥ 60 years〔OR=1.550,95%CI(1.386,1.733)〕,living in rural areas〔OR=1.241, 95%CI(1.065,1.446)〕,professional,technical and managerial workers〔OR=2.031,95%CI(1.038,3.974),retirees 〔OR=2.050,95%CI(1.073,3.915)〕,referral receivers〔OR=1.812,95%CI(1.190,2.758),follow-up receivers〔OR=1.624, 95%CI(1.047,2.517)〕,positive sputum smear results〔OR=1.622,95%CI(1.420,1.854)〕 and retreatment〔OR=1.859, 95%CI(1.545,2.237)〕 were risk factors of tuberculosis treatment failure(P<0.05).Age ≥ 60 years〔OR=2.462, 95%CI(2.038,2.975)〕,male〔OR=1.394,95%CI(1.174,1.656)〕,living in rural areas〔OR=1.265,95%CI(1.002, 1.598)〕,positive sputum smear results 〔OR=2.027,95%CI(1.652,2

关 键 词：结核 肺 治疗结果 影响因素分析 新疆 

分 类 号：R521[医药卫生—内科学]