2016—2021年河南省结核/艾滋病双重感染患者抗结核治疗转归及影响因素  

Outcomes of anti-tuberculosis treatment and its influencing factors for TB/HIV co-infected patients in Henan,2016-2021

作　　者：赵阿会 高敏 张沛 孙建伟[1] 甄新安[1] 蒋建国[1] 要玉霞[1] 孙定勇[1] ZHAO Ahui;GAO Min;ZHANG Pei;SUN Jianwei;ZHEN Xin'an;JIANG Jianguo;YAO Yuxia;SUN Dingyong(Institute ofTuberculosis Control and Prevention,Henan Centerfor Disease Control and Prevention,Zhengzhou,Henan 450016,China)

机构地区：[1]河南省疾病预防控制中心结核病预防控制所,河南郑州450016

出　　处：《现代疾病预防控制》2024年第7期523-526,548,共5页MODERN DISEASE CONTROL AND PREVENTION

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210153)。

摘　　要：目的分析结核/艾滋病(TB/HIV)双重感染患者的抗结核治疗效果,找出可能影响抗结核治疗成功的危险因素,为TB/HIV合并感染的预防和控制策略提供依据。方法选取2016—2021年在河南省结核病定点医疗机构登记并接受抗结核治疗的TB/HIV双重感染患者均纳入研究,采用logistic回归分析抗结核治疗转归情况,以确定影响治疗成功的因素。结果1232例患者中,男女比例3.43∶1,平均年龄(47.11±13.85)岁,多为农民(1045例,84.82%)。成功抗结核治疗1167例(94.72%),其中,治愈439例,治愈率35.63%;完成疗程728例,完成治疗率59.09%。未成功治疗56例,未成功治疗率4.55%,未成功治疗的原因主要是非结核死亡,占1.87%。多因素logistic回归分析显示,已知HIV检查阳性(OR=2.053,95%CI:1.157~3.643)是TB/HIV双重合并感染患者抗结核治疗不成功的显著危险因素。结论已知HIV检查阳性TB/HIV合并感染患者抗结核治疗未成功的风险更高,这可能导致不良后果。表明有必要加强健康教育,监测此类人群的结核治疗效果,以提高治疗成功率。Objective To analyze the outcomes of anti-tuberculosis treatment for TB/HIV co-infected patients,identify risk factors that might affect the success of this treatment,and inform strategies for the prevention and control of TB/HIV co-infection.Methods TB/HIV co-infected patients registered in TB designated hospitals and received anti-tuberculosis treatment in Henan Province from 2016 to 2021 were included in the study.The outcomes of anti-tuberculosis treatment were analyzed using logistic regression to determine factors that influence the success of the treatment.Results Of the 1232 patients,the male to female ratio was 3.43∶1,with an average age of(47.11±13.85)years;mostly farmers(1045,84.82%).A total of 1167 cases were successfully treated(94.72%).Of which 439 cases were cured,representing a cure rate of 35.63%.A total of 728 patients completed the course of treatment,with a completion rate of 59.09%,a total of 56 cases were not successfully treated resulting in an unsuccessful treatment rate of 4.55%.The main reason for unsuccessful treatment was deaths from non-tuberculosis diseases,accounting for 1.87%of the cases.Multivariate logistic regression analysis identified that a known positive HIV test(OR=2.053,95%CI:1.157-3.643)was a significant risk factor for unsuccessful anti-tuberculosis treatment in TB/HIV co-infected patients.Conclusions The study concludes that TB/HIV co-infected patients with a known positive HIV tests are at higher risk of unsuccessful anti-TB treatment,which may lead to adverse consequences.It suggests that there is a need to enhance health education and monitor the effectiveness of TB treatment in this population to improve the rate of successful treatment.

关 键 词：结核/艾滋病双重感染 治疗 转归 影响因素 

分 类 号：R52[医药卫生—内科学] R512.91[医药卫生—临床医学]