公众上呼吸道感染症状的潜在模式及其对抗生素使用行为的影响研究  

The Potential Patterns of Symptoms of Upper Respiratory Tract Infections in the Public and Their Effects on Antibiotic Use Behavior

作　　者：张欣怡 王茜 王丹 段立霞 林如娇 刘晨曦[1] ZHANG Xinyi;WANG Xi;WANG Dan;DUAN Lixia;LIN Rujiao;LIU Chenxi(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China;School of Management,Hubei University of Chinese Medicine,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北省武汉市430000 [2]湖北中医药大学管理学院,湖北省武汉市430000

出　　处：《中国全科医学》2024年第5期527-534,共8页Chinese General Practice

基　　金：国家自然科学基金资助项目(71904053,72004066)。

摘　　要：背景抗生素滥用导致的耐药问题已成全球重大公共卫生议题,减少公众上呼吸道感染的抗生素不合理使用是我国治理抗生素滥用的重要策略,识别上呼吸道感染疾病病症特点及其对抗生素不合理使用行为的影响有助于临床医生设计更为精准的干预政策。目的定量分析公众上呼吸道感染症状的潜在模式,探究其对抗生素使用行为的影响。方法本研究采用整群随机抽样调查,于2022-07-20—08-02选取重庆市三个县(区)的人群作为调查对象。调查公众上呼吸道感染疾病症状、公众上呼吸道感染抗生素使用行为、公众抗生素使用知识及人口学特征。采用潜在类别分析方法鉴别公众上呼吸道感染疾病症状的潜在模式,采用多因素Logistic回归分析探索不同潜在症状模式对抗生素使用行为的影响。结果815位公众参与本研究。其中,30.06%(245/815)受访者存在无处方从药店购买抗生素,14.72%(120/815)受访者使用过抗生素自我药疗以应对上呼吸道感染。公众抗生素合理使用知识水平较低[(2.3±1.7)分]。上呼吸道感染疾病发病模式方面,潜在类别分析共识别4种症状模式,包括多重症状组93例(11.41%)、全身症状组124例(15.21%)、鼻咽症状组282例(34.60%)和轻微症状组316例(38.77%)。多因素Logistic回归分析结果显示:相较于轻微症状组,鼻咽症状组出现无处方购买抗生素行为的概率更高(OR=1.538,P<0.05),该结果在调整知识与人口学变量后仍显著。除个体疾病症状潜在模式外,年龄和医保类型也对公众无处方抗生素购药行为有影响(P<0.05)。抗生素使用知识水平对抗生素自我药疗行为有影响(OR=0.869,P<0.05),对公众无处方抗生素购药行为也有影响(OR=1.155,P<0.05)。结论公众上呼吸道感染症状存在4种潜在模式,疾病病症模式影响公众抗生素的合理使用,应着重关注出现鼻咽症状患者的抗生素不合理使用行为。Background Antibiotic resistance caused by antibiotic abuse has become a public health issue worldwide.Reducing the irrational use of antibiotics for upper respiratory tract infections(URTIs)among the public is an important strategy to address the antibiotics abuse in China.Therefore,identifying the characteristics of URTIs in the population and their influence on the irrational use of antibiotics can help to design more targeted policies and interventions.Objective To quantify the potential patterns of symptoms of URTIs in the pulic,and explore their effect on antibiotic use behavior.Methods The public in three counties(districts)of Chongqing Municipality from July 20 to August 2,2022 were selected as the survey respondents by using the cluster random sample method.The symptoms of URTIs,antibiotic use behavior,antibiotic use knowledge and demographics of the public were collected.Latent class analysis was used to identify the potential patterns of the public URTIs symptoms.Multivariate Logistic regression analysis was used to explore the influence of URTIs potential patterns on antibiotic use behavior.Results In this study,a total of 815 participants were included.Among them,30.06%(245/815)of the respondents purchased antibiotics from pharmacies without a prescription,while 14.72%(120/815)of the respondents self-medicated with antibiotics for URTIs.The public knowledge level regarding rational antibiotic use was relatively low,with an average score of(2.3±1.7)points.Four symptom patterns for upper respiratory tract infections identified by latent class analysis regarding the disease pattern of URTIs,including 93 cases(11.41%)in the diverse symptoms group,124(15.21%)cases in the systemic symptoms group,282 cases(34.60%)in the nasalpharyngeal symptoms group,and 316 cases(38.77%)in the mild symptoms group.The results of multivariate Logistic regression analysis showed that compared with the mild symptoms group,the nasal-pharyngeal symptoms group had a higher probability of purchasing antibiotics without a prescrip

关 键 词：呼吸道感染 抗菌药 抗生素合理使用 体征和症状 潜在类别分析 LOGISTIC模型 

分 类 号：R517.6[医药卫生—内科学]