慢性乙型肝炎患者抗病毒治疗期间自我停药状况及影响因素  

The influencing factors of self withdrawal in patients with chronic hepatitis B during antiviral treatment

作　　者：钟丽梅[1] 唐霏林 杨柳琴 陆艳珍 黄桂敏[1] 黄艳[1] ZHONG Limei;TANG Feilin;YANG Liuqin(Emergency Department,Affiliated Hospital of Youjiang National Medical College,Guangxi,Baise 533000,China)

机构地区：[1]右江民族医学院附属医院急诊科,广西壮族自治区百色市533000

出　　处：《河北医药》2021年第17期2614-2617,共4页Hebei Medical Journal

基　　金：百色市科学研究与技术开发计划项目(编号:20184713)。

摘　　要：目的观察慢性乙型肝炎(chronic hepatitis B,CHB)患者抗病毒治疗期间自我停药状况,分析CHB患者抗病毒治疗期间自我停药的影响因素。方法回顾性分析2018年7月至2020年7月500例接受抗病毒治疗的CHB患者资料,统计患者治疗期间自我停药状况,纳入可能的影响因素,行单因素与多因素分析找出CHB患者抗病毒治疗期间自我停药的影响因素。结果500例接受抗病毒治疗的CHB患者治疗期间107例自我停药,自我停药发生率21.40%;初步比较发生与未发生自我停药患者基线资料,将比较差异有统计学意义的变量纳入行单项Logistic回归分析,后将全部资料纳入建立多元回归模型,行多因素分析,结果显示医疗支付方式(全自费)、抗病毒治疗药物[核苷(酸)类似物(NAs)]、疾病知识水平低、领悟社会支持水平低均是CHB患者抗病毒治疗期间自我停药的影响因素(OR值为3.209、2.152、9.162、2.082,P<0.05)。结论CHB患者抗病毒治疗期间有较高的自我停药风险,可能与医疗支付方式、抗病毒治疗药物、疾病知识水平、领悟社会支持有关,临床应重视上述风险因素,针对早期评估存在自我停药风险因素的患者应实施合理干预。Objective To investigate the self withdrawal status of patients with chronic hepatitis B(CHB)during antiviral treatment,and to analyze the related influencing factors.Methods The clinical data about 500 patients with CHB who received antiviral treatment in our hospital from July 2018 to July 2020 were retrospectively analyzed,including self withdrawal status,moreover,the possible influencing factors were analyzed by using univariate and multivariate analysis.Results Of the 500 patients with CHB who received antiviral therapy,there were 107 cases of self withdrawal during treatment,with the incidence of self withdrawal being 21.40%.The multiple regression analysis results showed that medical payment(all self payment),antiviral drugs[nucleoside acid analogues(NAS)],low level of disease knowledge and low level of perceived social support were the influencing factors of self withdrawal of patients with CHB during antiviral treatment(OR>1,P<0.05).Conclusion The patients with CHB have higher risks of self withdrawal during antiviral treatment,which may be related to medical payment,antiviral drugs,disease knowledge level and perceived social support,therefor,it is necessary to pay much attention to the above risk factors,to take early assessment for the patients with self withdrawal risk factors,and to perform reasonable intervention.

关 键 词：慢性乙型肝炎 抗病毒治疗 自我停药 用药 疾病知识水平 领悟社会支持 

分 类 号：R512.62[医药卫生—内科学]