初治涂阳肺结核患者强化期治疗后空洞进展影响因素分析  

Analysis of influencing factors of cavity progression after intensive treatment in newly treated smear-positive pulmonary tuberculosis patients

作　　者：丰银平 郭净 刘忠达 FENG Yinping;GUO Jing;LIU Zhongda(Lishui Hospital of Traditional Chinese Medicine,Affiliated to Zhejiang University of Traditional Chinese Medicine,Zhejiang,Lishui 323000,China)

机构地区：[1]浙江中医药大学附属丽水中医院,浙江丽水323000

出　　处：《中国现代医生》2022年第29期31-34,共4页China Modern Doctor

摘　　要：目的分析初治涂阳肺结核患者经强化期治疗后空洞进展的影响因素,为更有效防治肺结核提供依据。方法选取2021年1月至2022年3月浙江中医药大学附属丽水中医院收治的初治涂阳肺结核伴空洞患者139例作为研究对象。根据强化期治疗结束复查胸部CT肺部空洞吸收情况,将空洞闭合及空洞缩小≥原空洞直径1/2作为空洞好转组(n=101),将空洞增大>原空洞1/2作为空洞进展组(n=38)。比较患者年龄、性别、是否吸烟、病程、是否合并糖尿病、体质量指数、前白蛋白、白蛋白、有无营养风险情况,采用多因素Logistic回归分析空洞进展的影响因素。结果多因素Logistic回归分析显示,吸烟[比值比(odds ratio,OR)=6.311,95%置信区间(confidence interval,CI):2.203~18.079,P=0.001]、合并糖尿病(OR=4.941,95%CI:1.763~13.843,P=0.002)、病程≥1个月(OR=3.495,95%CI:1.250~9.777,P=0.017)、有营养风险(OR=4.656,95%CI:1.691~12.818,P=0.003)均是空洞进展的影响因素(P<0.05)。结论吸烟、合并糖尿病、病程≥1个月、有营养风险的初治涂阳肺结核患者强化期治疗后空洞容易出现进展,应及早防治。Objective To analyze the influencing factors of cavitation progression after intensive treatment in newly treated smear–positive pulmonary tuberculosis patients,in order to provide evidence for more effective prevention and treatment of pulmonary tuberculosis.Methods A total of 139 patients admitted to Lishui Hospital of Traditional Chinese Medicine,Affiliated to Zhejiang University of Traditional Chinese Medicine,from January 2021 to March 2022 with primary treatment of smear–positive pulmonary tuberculosis with cavitation were selected.According to the resorption of cavities in the lungs on chest computer tomography at the end of the intensive treatment period,cavity closure and cavity reduction≥1/2 of the original cavity diameter were considered as the cavity improvement group(n=101),and cavity enlargement>1/2 of the original cavity was considered as the cavity progression group(n=38).Patients'age,gender,whether they smoked,duration of disease,whether they had combined diabetes,body mass index,prealbumin,albumin,and the presence of nutritional risk were compared.Factors influencing cavity progression were analysed using multi–factor logistic regression.Results Multivariate Logistic regression analysis showed that smoking[odds ratio(OR)=6.311,95%confidence interval(95%CI):2.203–18.079,P=0.001],combined with diabetes(OR=4.941,95%CI:1.763–13.843,P=0.002),disease course≥1 month(OR=3.495,95%CI:1.250–9.777,P=0.017),nutritional risk(OR=4.656,95%CI:1.691–12.818,P=0.003)is the influencing factor of cavity progression(P<0.05).Conclusion Smoking,combined with diabetes mellitus,disease course≥1 month,and nutritional risk in newly–treated smear–positive pulmonary tuberculosis patients are prone to progression of cavities after intensive treatment,and should be prevented and treated early.

关 键 词：肺结核 空洞 进展 影响因素 

分 类 号：R521[医药卫生—内科学]