2011—2020年江苏省利福平耐药肺结核患者转归情况及影响因素  

The treatment outcomes and influencing factors of rifampicin⁃resistant pulmonary tuberculosis in Jiangsu Province,2011⁃2020

作　　者：于全骥 陈诚[1] 宋红焕[1] 李国莉[1] 卢鹏 虞浩[1] YU Quan-ji;CHEN Cheng;SONG Hong-huan;LI Guo-li;LU Peng;YU Hao(Jiangsu Provincial Center for Disease Control and Prevention,Jiangsu Nanjing 210009,China)

机构地区：[1]江苏省疾病预防控制中心,江苏南京210009

出　　处：《江苏预防医学》2023年第3期256-259,共4页Jiangsu Journal of Preventive Medicine

基　　金：国家自然科学基金(82003516);江苏省卫生健康委员会科研重点项目(ZD2021052,ZDA2020022);江苏省卫生健康委员会科研面上项日(M2020020)。

摘　　要：目的分析江苏省利福平耐药肺结核患者转归情况及影响因素。方法从结核病信息管理系统中获取2011—2020年利福平耐药肺结核患者资料,包括性别、年龄、民族、职业、户籍、地区、治疗分类、治疗延迟分组情况,并对利福平耐药患者的转归、变化趋势进行分析,采用多因素logistic回归分析转归的影响因素。结果纳入利福平耐药肺结核患者2691例,2011—2020年治疗成功率年均67.86%,呈上升趋势(χ_(趋势)^(2)=91.44,P<0.01),不同地区间差异有统计学意义(χ^(2)=93.42,P<0.01)。治疗成功率:女性(72.89%)、年龄0~24岁(84.14%)、职业为学生及教师(87.21%)、苏南地区(73.51%)、初治(74.86%)、治疗未延误(69.98%),高于男性(66.21%)、年龄25~60岁(71.16%)/>60岁(53.89%)、职业为工人(77.05%)/农民(63.21%)/家务及待业(75.41%)/其他(70.95%)、苏中地区(58.19%)/苏北(67.85%)地区、复治(63.20%)、治疗延误(64.79%)患者,差异均有统计学意义(χ^(2)为7.58~109.18,P值均<0.05)。多因素logistic回归分析显示,年龄25~60岁和>60岁与0~24岁相比[OR=0.61(95%CI:0.42~0.88)和0.31(95%CI:0.21~0.46)],苏中与苏南地区相比[OR=0.65(95%CI:0.51~0.83)]、复治与初治相比[OR=0.70(95%CI:0.58~0.84)]、治疗延误与治疗未延误相比[OR=0.83(95%CI:0.70~0.99)],患者治疗成功的可能性更低,差异均有统计学意义(P值均<0.05)。结论2011—2020年江苏省利福平耐药患者的成功治疗率总体上升,应重点关注中老年、苏中地区、复治、治疗延误患者。Objective To analyze the treatment outcomes and influencing factors of rifampicin⁃resistant pulmonary tuberculosis in Jiangsu Province.Methods Information of patients with rifampicin⁃resistant pulmonary tuberculosis from 2011⁃2022 was obtained from the TB Management Information System,including gender,age,ethnicity,occupation,household registration,region,therapy classi⁃fication and treatment delay classification.The treatment outcomes and trend of rifampicin⁃resistant patients were analyzed,and the in⁃fluencing factors were identified by multivariate logistic regression.Result There were 2691 patients with rifampicin⁃resistant tuber⁃culosis,the treatment success rate showed an increasing trend(χ^(2)_(trend)=91.44,P<0.01),with an average success rate of 67.86%.There were statistically significant differences in treatment success rates among 13 cities(χ^(2)=93.42,P<0.01).Univariate analysis showed that the treatment success rates of female(72.89%),aged 0~24(84.14%),occupation as student/teacher(87.21%),the southern region of Jiangsu Province(73.51%),therapy classification as initial⁃treated(74.86%),without treatment delay(69.98%),which were higher than those of male(66.21%),aged 25~60(71.16%)/>60(53.89%),occupation as worker(77.05%)/farmer(63.21%)/housework and unemployed workers(75.41%)/others(70.95%),the central(58.19%)/northern(67.85%)regions of Jiangsu Province,therapy classification as retreated(63.20%),treatment delay(64.79%),and the differences were statistically signifi⁃cant(χ^(2)=7.58⁃109.18,all P<0.05).Multivariate logistic regression analysis showed that the treatment success rate of aged 25~60[OR=0.61(CI:0.42~0.88)]and>60[OR=0.31(CI:0.21~0.46)](reference as aged 0~24),the central region of Jiangsu Province[OR=0.65(CI:0.51~0.83)](reference as the north region),therapy classification as retreated[OR=0.70(CI:0.58~0.84)](reference as initial⁃treated),treatment delay[OR=0.83(CI:0.70~0.99)](reference as without treatment delay)were lower.Conclusions From 2011⁃2020,the treatment s

关 键 词：肺结核 利福平 药物耐受性 转归 

分 类 号：R521[医药卫生—内科学]