天津市肺结核患者短程督导治疗期抗结核治疗效果及死亡影响因素分析  

Treatment effect and risk factors of mortality among pulmonary tuberculosis patients with directly observed treatment short-course in Tianjin city

作　　者：谢祎[1,2] 韩晶 于维莉[1] 李静[3] 孙昕[2,4] XIE Yi;HAN Jing;YU Wei-li(Department of Prevention,Tianjin Haihe Hospital,Tianjin 300350,China)

机构地区：[1]天津市海河医院预防科,300350 [2]天津市呼吸疾病研究所 [3]天津市海河医院结核科 [4]天津市海河医院呼吸科

出　　处：《中国公共卫生》2020年第1期126-129,共4页Chinese Journal of Public Health

基　　金：天津市医院协会医院管理研究项目（2018zc11）;天津市科技计划项目（16ZXHLSY00130）

摘　　要：目的了解天津市肺结核患者短程督导治疗期抗结核治疗效果及死亡的影响因素,为降低肺结核病死率提供参考依据。方法采用回顾性队列分析方法收集天津市2014-2016年结核病管理信息系统中5052例肺结核患者督导期抗结核治疗转归情况,应用Kaplan-Meier法和多因素Cox比例风险回归模型分析患者短程督导治疗期死亡的影响因素。结果天津市5052例肺结核患者的抗结核治疗成功率为90.40%,病死率为4.67%;多因素Cox回归分析结果显示,年龄较大、人类免疫缺陷病毒(HIV)阳性、首次痰菌结果阳性、复治肺结核和就诊延误≥14 d为天津市肺结核患者短程督导治疗期死亡的危险因素,女性为天津市肺结核患者短程督导治疗期死亡的保护性因素。结论天津市肺结核患者短程督导治疗期抗结核治疗效果较好;男性、年龄较大、HIV阳性、首次痰菌结果阳性、复治肺结核、就诊延误≥14 d的肺结核患者在抗结核治疗期内死亡风险较大。Objective To explore treatment effect and risk factors of mortality among patients with pulmonary tuberculosis(TB)with directly observed treatment short-course(DOTS)in Tianjin municipality and to provide evidences for reducing TB-related mortality.Methods From National TB Management Information System,we retrieved clinical data and treatment outcome among 5052 TB patients registered in Tianjin municipality and with DOTS from 2014 through 2016 and analyzed the data retrospectively.Kaplan-Meier method and multivariate Cox proportional risk regression model were used to analyze the risk factors of mortality during DOTS.Results For all the patients,the success rate of DOTS was 90.40%and the mortality rate was 4.67%.Cox regression analysis revealed that at older age,human immunodeficiency virus(HIV)-positive,first sputum smear-positive for Mycobacterium tuberculosis(MT),being retreated,and with a delayed seeking medication of 14 day or more were risk factors of mortality during DOTS in the TB patients;while,being female was protective factor against mortality during DOTS.Conclusion During 2014–2016 among TB patients registered in Tianjin municipality,the outcome of DOTS was good and the patients being male,at older age,HIV-positive,first sputum smear-positive for Mycobacterium tuberculosis(MT),being retreated,with a delayed seeking medication of 14 day or more were at a higher mortality risk.

关 键 词：肺结核 抗结核治疗 效果 死亡 影响因素 短程督导治疗期 

分 类 号：R181.3[医药卫生—流行病学]