新疆喀什地区初治肺结核患者成功治疗后复发影响因素分析  

Analysis of influencing factors of recurrence after successful treatment in new pulmonary tuberculosis patients in Kashgar Prefecture,Xinjiang Uygur Autonomous Region

作　　者：麦维兰江·阿不力米提 地尔木拉提·吐孙 克尤木·吾布力喀斯木 穆萨·艾海提 刘振江 李宾 西日扎提·马木提 陈金瓯[3] 李涛[4] 苏伟[4] 赵雁林[4] 欧喜超[4] Maiweilanjiang·Abulimiti;Diermulati·Tusun;Keyoumu·Wubulikasimu;Musa·Aihaiti;Liu Zhenjiang;Li Bin;Xirizhati·Mamuti;Chen Jinou;Li Tao;Su Wei;Zhao Yanlin;Ou Xichao(Division of Tuberculosis Clinic,Tuberculosis Dispensary of Kashgar Prefecture,Kashgar 844000,China;Department of Gastroenterology,Shandong First Medical University Affiliated Provincial Hospital,Ji’nan 250021,China;Department of Tuberculosis Prevention and Control,Yunnan Provincial Center for Disease Control and Prevention,Kunming 650034,China;National Center for Tuberculosis Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]喀什地区结核病防治所暨肺科医院结核病门诊,喀什844000 [2]山东第一医科大学附属省立医院消化内科,济南250021 [3]云南省疾病预防控制中心结核病防治科,昆明650034 [4]中国疾病预防控制中心结核病预防控制中心,北京102206

出　　处：《中国防痨杂志》2022年第11期1148-1153,共6页Chinese Journal of Antituberculosis

基　　金：新疆维吾尔自治区科技厅自然科学基金(2021A01D145)。

摘　　要：目的:分析喀什地区初治肺结核患者成功治疗后复发的影响因素,为制定干预措施减少喀什地区结核病患者复发提供科学依据。方法:采用分层整群抽样方法,选取截止到2021年12月31日,2015年喀什地区登记并成功治疗的初治肺结核患者中的复发(216例)和未复发(216例)患者为调查对象,按照性别和年龄进行1∶1对照匹配,对432例初治肺结核患者开展问卷调查,采用多因素logistic回归分析肺结核治疗成功后复发的主要影响因素。结果:多因素logistic回归分析发现:体质量指数>24.00(OR=4.235,95%CI:1.277~7.877)、文化程度为小学(OR=3.434,95%CI:1.861~6.337)、中等收入(OR=2.240,95%CI:1.256~3.993)、未规范治疗(OR=3.436,95%CI:1.788~6.606)、吸烟(OR=3.970,95%CI:1.419~11.113)是结核病复发的独立危险因素。无结核病密切接触史(OR=0.256,95%CI:0.137~0.477)和集中服药(OR=0.103,95%CI:0.026~0.413)的结核病患者不易复发。结论:落实喀什地区肺结核患者集中服药管理,对有结核病密切接触史和吸烟人群及时开展针对性干预措施,可有效降低肺结核患者复发。Objective:To analyze the influencing factors of recurrence after successful treatment in new pulmonary tuberculosis(PTB)patients in Kashgar Prefecture,and to provide scientific basis for formulating intervention measures to reduce the recurrence of PTB in Kashgar Prefecture.Methods:Using the stratified cluster sampling method,as of December 31,2021,216 recurrent and 216 non-recurrent new PTB patients registered and successfully treated in Kashgar Prefecture in 2015 were selected as the survey objects and were matched 1∶1 according to gender and age.A questionnaire survey was conducted on those 432 patients,and multivariate logistic regression was used to analyze the main influencing factors of PTB recurrence after successful treatment.Results:Multivariate logistic analysis indicated:body mass index>24.00(OR=4.235,95%CI:1.277-7.877),education level being new school(OR=3.434,95%CI:1.861-6.337),middle-income(OR=2.240,95%CI:1.256-3.993),unstandardized anti-TB treatment(OR=3.436,95%CI:1.788-6.606),smoking(OR=3.970,95%CI:1.419-11.113)were independent risk factors for TB recurrence.Patients with no history of close contact with other TB patients(OR=0.256,95%CI:0.137-0.477)and patients receiving centralized medication(OR=0.103,95%CI:0.026-0.413)were less likely to recurrent.Conclusion:Implementing centralized medication management for tuberculosis patients in Kashgar Prefecture,and timely implementation of targeted interventions for smokers and people with a history of close contact with other TB patients,can effectively reduce the recurrence of PTB.

关 键 词：结核 肺 复发 因素分析 统计学 

分 类 号：R52[医药卫生—内科学] R45[医药卫生—临床医学]