202例初治涂阳肺结核患者治愈后复发的影响因素分析  

The influencing factors of recurrence after cure in 202 newly treated smear-positive pulmonary tuberculosis patients

作　　者：刘荣华 李文雅 王利彩 LIU Rong-hua;LI Wen-ya;WANG Li-cai(Department of Tuberculosis,Fifth People's Hospital of Puyang City,Henan 457000,China;Department of Respiratory Medicine,People's Hospital,Henan 457000,China)

机构地区：[1]濮阳市第五人民医院结核科,河南457000 [2]濮阳市人民医院呼吸内科,河南457000

出　　处：《安徽预防医学杂志》2023年第2期137-141,共5页Anhui Journal of Preventive Medicine

摘　　要：目的 分析202例初治涂阳肺结核患者治愈后复发的影响因素。方法 选取濮阳市第五人民医院2017年4月—2019年7月收治202例初治涂阳肺结核患者,治愈后随访2年,根据是否复发将患者分为复发组(15例)和未复发组(187例)。收集两组患者性别、年龄、职业、文化程度等一般资料以及是否合并糖尿病、低蛋白、初诊痰涂片菌量等临床资料。采用logistic回归模型分析初治涂阳肺结核患者治愈后复发的危险因素。结果 202例初治涂阳肺结核患者治愈后2年复发率为7.43%(15/202);两组年龄、合并糖尿病、痰菌转阴时间、停药残留空洞、初诊痰涂片菌量比较,差异均有统计学意义(P值均<0.05)。logistic回归分析显示,年龄≥60岁(OR=6.799,95%CI:2.847~16.239),合并糖尿病(OR=4.622,95%CI:1.159~18.436),痰菌转阴时间≥3个月(OR=7.336,95%CI:3.622~14.858),停药残留空洞(OR=8.439,95%CI:4.182~17.031),初诊痰涂片菌量为2+(OR=5.526,95%CI:1.657~18.426)、3+(OR=7.039,95%CI:3.522~14.067)、4+(OR=9.979,95%CI:5.071~19.639)是初治涂阳肺结核患者治愈后复发的影响因素。结论 初治涂阳肺结核患者治愈后2年内,存在一定水平复发率,患者的年龄越大、合并糖尿病、痰菌转阴时间、停药残留空洞、初诊痰涂片菌量多是影响初治涂阳肺结核患者治愈后复发的因素。Objective To analyze the influencing factors of recurrence after cure in 202 newly treated smear-positive pulmo-nary tuberculosis patients.Methods A total of 202 newly treated smear-positive pulmonary tuberculosis patients were se-lected from April 2017 to July 2019 in Puyang Fifth People's Hospital.After treatment,they were followed up for two years.The patients were divided into recurrent group(15 cases)and non-recurrent group(187 cases)according to whether they recurred.The general data such as gender,age,occupation,education level,and clinical data such as whether diabetes,low protein,and the amount of sputum smear bacteria at the first diagnosis were collected and compared between the two groups.Logistic regression model was used to analyze the risk factors of recurrence in patients with smear-positive pulmonary tuberculosis after treatment.Results The recurrence rate of 202 patients with smear-positive pulmonary tuberculosis was 7.43%(15/202)after 2 years of cure.There were significant differences between the two groups in age,diabetes,time of sputum bacteria turning negative,residual cavity after drug withdrawal,and bacterial count of sputum smear at the first diag-nosis(P<0.05).Logistic regression analysis showed that the patients were≥60 years old(OR=6.799,95%CI:2.847-16.239),complicated with diabetes(OR=4.622,95%CI:1.159-18.436),the time of sputum bacteria turning negative was≥3 months(OR=7.336,95%CI:3.622-14.858),residual cavities after drug withdrawal(OR=4.182,95%CI:4.182-17.031),and the amount of sputum smear bacteria at the first diagnosis was 2+(OR=5.526,95%CI:1.657-18.426),3+(OR=7.039,95%CI:3.522-14.067),4+(OR=9.979,95%CI:5.071-19.639),were the influencing factors of relapse af-ter cure in the patients with smear-positive pulmonary tuberculosis.Conclusion There is a certain level of recurrence rate in the first treatment smear-positive pulmonary tuberculosis patients within 2 years after cure.The older the patients are,the combination of diabetes,the time of sputum bacteria turning negative,th

关 键 词：肺结核 复发 影响因素 LOGISTIC分析 

分 类 号：R521[医药卫生—内科学]