上海市耐多药肺结核患者治疗结局相关因素研究  

Study on treatment outcome and risk factors of multidrug-resistant pulmonary tuberculosis patients in Shanghai

作　　者：宁晨曦 张诗琦 吴哲渊[1] 陈静[1] 张祖荣[1] 沈鑫[1] 袁政安[1,2] NING Chenxi;ZHANG Shiqi;WU Zheyuan;CHEN Jing;ZHANG Zurong;SHEN Xin;YUAN Zheng'an(Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海市疾病预防控制中心,上海200336 [2]上海中医药大学,上海201203

出　　处：《上海预防医学》2023年第3期219-223,共5页Shanghai Journal of Preventive Medicine

基　　金：国家自然科学基金(81872679);上海市科技创新行动计划(21DZ2202400);上海市公共卫生优秀学科带头人项目(GWV-10.2-XD23)。

摘　　要：【目的】了解上海市2017—2018年纳入二线治疗的耐多药肺结核(MDR-TB)患者的治疗结局特征,分析影响其治疗结局的因素。【方法】利用中国结核病管理信息系统、医院电子病历信息系统、全基因组测序结果及问卷调查收集的数据,对182例MDR-TB患者进行治疗结局特征描述,应用logistic回归分析影响治疗成功与否的因素。【结果】182例MDR-TB患者的治疗成功率为65.4%,失访率为8.2%,死亡率为4.9%,无法评估率为13.7%,停药率为7.7%。影响MDR-TB患者治疗成功与否的因素包含年龄35~岁(OR=5.28,95%CI:1.58~17.59,P=0.007)、55~岁(OR=16.30,95%CI:4.36~60.92,P<0.001)和治疗依从性(OR=0.55,95%CI:0.42~0.72,P<0.001)。【结论】2017—2018年上海市MDR-TB患者治疗成功率高于国内平均水平,年龄越大、治疗依从性越差的患者出现不良治疗结局的风险越大。[Objective]To describe the characteristics of treatment outcomes of multidrug-resistant tuberculosis(MDR-TB)patients enrolled in second-line treatment in Shanghai from 2017 to 2018,and to analyze the influencing factors of treatment outcomes.[Methods]Totally 182 MDR-TB patients were analyzed by using data collected from the China tuberculosis management information system,the hospital's electronic medical record information system,whole genome sequencing results and a questionnaire survey,and logistic regression analysis was used to analyze the factors affecting the success of treatment.[Results]In 182 MDR-TB patients,the success rate of treatment was 65.4%,the loss to follow-up rate was 8.2%,the mortality rate was 4.9%,the unassessable rate was 13.7%,and the drug withdrawal rate was 7.7%.The factors affecting the success of treatment in MDR-TB patients included age(35‒years old,OR=5.28,95%CI:1.58‒17.59,P=0.007;55‒years old,OR=16.30,95%CI:4.36‒60.92,P<0.001)and compliance to medication(OR=0.55,95%CI:0.42‒0.72,P<0.001).[Conclusion]The treatment success rate of MDR-TB patients in Shanghai from 2017 to 2018 is significantly higher than the average level in China.Older patients and patients with less compliant are at higher risk of adverse treatment outcomes.

关 键 词：耐多药肺结核患者 治疗结局 影响因素 

分 类 号：R183[医药卫生—流行病学]