387名结核分枝杆菌潜伏感染者预防性治疗服药完成情况及影响因素分析  

Analysis of treatment completeness and its influencing factors of preventive treatment among 387 latent tuberculosis infection cases

作　　者：加依那提·金格斯 王新旗[2,3] 刘年强 王森路 依帕尔·艾海提 冯建宇[4] 黄涛 克地尔叶克孜·吾甫尔 Jiayinati Jingesi;Wang Xinqi;Liu Nianqiang;Wang Senlu;Yipaer Aihaiti;Feng Jianyu;Huang Tao;Kedieryekezi Wufuer(School of Public Health,Xinjiang Medical University,Urumqi 830017,China;Tuberculosis/Leprosy Control Center,Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region,Urumqi 830002,China;Department of Tuberculosis Prevention and Control,Center for Disease Control and Prevention of Bayinguoleng Mongolia Autonomous Prefecture,Korla 841499,China;Department of Tuberculosis Prevention and Control,Aksu Regional Center for Disease Control and Prevention,Aksu 843000,China)

机构地区：[1]新疆医科大学公共卫生学院,乌鲁木齐830017 [2]新疆维吾尔自治区疾病预防控制中心结核病/麻风病防治中心,乌鲁木齐830002 [3]巴音郭楞蒙古自治州疾病预防控制中心结核病防治科,库尔勒841499 [4]阿克苏地区疾病预防控制中心结核病防治科,阿克苏843000

出　　处：《中国防痨杂志》2024年第12期1496-1503,共8页Chinese Journal of Antituberculosis

基　　金：“天山英才”医药卫生高层次人才培养计划(TSYC202301B166);新疆维吾尔自治区自然科学基金(2023D01C57);公共卫生人才培养项目(01063局)。

摘　　要：目的:研究肺结核患者密切接触者中的结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)者对3个月每周服用2次异烟肼和利福喷丁联合间歇(3H-P)预防性治疗方案的服药完成情况及影响服药完成的因素,为进一步推广预防性治疗措施提供参考依据。方法:收集2023年1月1日至12月31日期间,新疆维吾尔自治区(简称“新疆”)阿克苏地区乌什县经知情同意纳入的387名与肺结核患者密切接触的接受预防性治疗的LTBI者作为研究对象。通过问卷调查,了解预防性治疗服药完成情况及其影响因素。问卷主要内容包括基本人口学信息、结核病防治核心知识知晓情况及预防性治疗服药情况等。采用单因素和多因素logistic回归分析与预防性服药完成情况相关的影响因素。结果:387名LTBI者中,有355名完成3H-P方案服药,服药完成率为91.73%;不良反应发生率为14.21%(55/387),因不良反应停药率为4.39%(17/387)。多因素logistic回归分析结果显示,规律运动(OR=5.337,95%CI:2.309~12.337)、参与结核病防治相关培训(OR=4.406,95%CI:1.942~9.994)是肺结核患者密切接触者中的LTBI者完成服药的保护因素;有饮酒史(OR=0.279,95%CI:0.108~0.720)、年龄在50~64岁(OR=0.254,95%CI:0.092~0.698)是肺结核患者密切接触者中的LTBI者中断服药的危险因素。结论:肺结核患者密切接触者中的LTBI者预防性治疗的服药完成情况总体良好,不良反应为中断服药的原因之一,服药完成率还会受到未规律运动、有饮酒史、未参与过结核病防治相关培训、年龄50~64岁等因素的影响。Objective:To study the treatment completeness and its influencing factors of 3H-P preventive treatment among close contacts of tuberculosis patients with latent tuberculosis infection(LTBI)and to provide a reference for further promotion of preventive treatment.Methods:Between January 1,2023 and December 31,2023,387 LTBI cases who had close contact with tuberculosis patients and received preventive treatment with informed consent from Wushi County,Aksu Prefecture,Xinjiang Uygur Autonomous Region(Xinjiang)were enrolled as research subjects.A questionnaire was used to collect information of the completion of preventive treatment and its influencing factors,mainly including basic demographic information,awareness of tuberculosis prevention and control core knowledge,completion of preventive treatment,etc.Univariable and multivariable logistic regression were used to analyze the influencing factors related to the completion of preventive treatment.Results:Among 387 LTBI cases,355 completed preventive treatment,with a treatment completion rate of 91.73%.The incidence of adverse reactions was 14.21%(55/387),and 4.39%(17/387)of cases discontinued their treatment due to adverse reactions.Multivariable logistic regression analysis indicated that taking exercise regularly(OR=5.337,95%CI:2.309-12.337)and attending training on tuberculosis prevention and control(OR=4.406,95%CI:1.942-9.994)were protective factors for completion of preventive treatment,while a history of alcohol consumption(OR=0.279,95%CI:0.108-0.720)and aged 50-64 years(OR=0.254,95%CI:0.092-0.698)were risk factors for completion of treatment.Conclusion:Completion of preventive treatment among close contacts of tuberculosis patients with LTBI was generally good,with adverse reactions being one of the main reasons for interruption of treatment.The completion rate of their treatment was affected by not exercising regularly,history of alcohol consumption,not attending training on tuberculosis prevention and control,and aged 50-64 years.

关 键 词：结核 肺 接触者追踪 抗结核药 预防和防护用药 因素分析 统计学 

分 类 号：R521[医药卫生—内科学]