2011—2021年河南省耐多药结核病患者治疗结局及生存分析  

Analysis of treatment outcome and survival of patients with multi-drug resistant tuberculosis in Henan Province from 2011 to 2021

作　　者：王硕 王伟东 何梦雅 张艳秋[1] 孙定勇[1] WANG Shuo;WANG Wei-dong;HE Meng-ya;ZHANG Yan-qiu;SUN Ding-yong(Henan Center for Disease Control and Prevention,Zhengzhou,Henan 450016,China)

机构地区：[1]河南省疾病预防控制中心,河南郑州450016

出　　处：《现代预防医学》2024年第9期1713-1718,共6页Modern Preventive Medicine

基　　金：河南省科技发展计划(212102310156);河南省医学科技攻关计划联合共建项目(LHGJ20200130)。

摘　　要：目的了解河南省耐药结核病患者死亡的相关影响因素。方法选取河南省全部18个地级市以及2个直管县,2011—2021年期间确诊的结核病患者资料,筛选出具有完整疗程记录及治疗结局的患者,使用Kaplan-Meier法计算患者累积生存率,Cox比例风险回归识别可能影响患者生存时间的因素。结果1078例耐药结核病患者中,死亡患者共计66例(6.1%),30个月内累积生存率为90.1%,50%患者的死亡发生在10个月以内。在控制了其他因素后,年龄(HR=1.053,95%CI:1.029~1.087)、广泛耐药结核病(XDR-TB)(HR=3.032,95%CI:1.584~5.767)、吸烟(HR=1.879,95%CI:1.006~3.509)、BMI(HR=0.294,95%CI:0.088~0.978)是影响结核病患者治疗期间死亡的主要危险因素。结论河南省耐药结核病患者中,老年、XDR-TB、有吸烟习惯以及BMI小于18.5 kg/m^(2)的患者具有相对更高的死亡风险,为这些患者的治疗提供额外的支持以减少患者死亡率。Objective To investigate the related factors of death in patients with drug-resistant tuberculosis in Henan Province.Methods The data of tuberculosis patients diagnosed in all 18 prefecture-level cities and 2 directly administered counties in Henan Province from 2011 to 2021 were selected.The patients with complete course of treatment and treatment outcome were selected.The cumulative survival rate was calculated by Kaplan-Meier method,and Cox proportional hazard regression was used to identify the factors affecting the survival time of patients.Results Among the 1078 patients with drug-resistant tuberculosis,a total of 66 patients(6.1%)died,and the cumulative survival rate within 30 months was 90.1%.In total 50%of the patients died within 10 months.After controlling other factors,age(HR=1.053,95%CI:1.029-1.087),XDR-TB patients(HR=3.032,95%CI:1.584-5.767),smoking(HR=1.879,95%CI:1.006-3.509)and BMI(HR=0.294,95%CI:0.088-0.978)were the main risk factors for death of tuberculosis patients during treatment.Conclusion Among drug-resistant tuberculosis patients in Henan Province,elderly patients,XDR-TB patients,smoking patients and patients with BMI less than 18.5 have a relatively higher risk of death.Additional support should be provided for the treatment of these patients to reduce mortality.

关 键 词：生存分析 耐多药结核 广泛耐药结核 危险因素 

分 类 号：R521[医药卫生—内科学]