2018—2023年贵州省利福平敏感MTB/HIV双重感染患者流行特征及治疗转归分析  

Characteristics and treatment outcome analysis of MTB/HIV dual infection patients in Guizhou Province from 2018 to 2023

作　　者：李福栋 马晓雪 周建 王大福 张玥颖 龚婷婷 饶文 洪峰[1] 李世军[2] 李进岚 Li Fudong;Ma Xiaoxue;Zhou Jian;Wang Dafu;Zhang Yueying;Gong Tingting;Rao Wen;Hong Feng;Li Shijun;Li Jinlan(School of Public Health,the Key Laboratory of Environmental Pollution Monitoring and Disease Control,Ministry of Education,Guizhou Medical University,Guiyang 550025,China;Guizhou Provincial Center for Disease Control and Prevention,Guiyang 550000,China)

机构地区：[1]贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵阳550025 [2]贵州省疾病预防控制中心,贵阳550000

出　　处：《中国防痨杂志》2025年第1期36-43,共8页Chinese Journal of Antituberculosis

基　　金：贵州省发改委省级基本建设前期工作项目(2020-181-131)。

摘　　要：目的:分析2018—2023年贵州省利福平敏感MTB/HIV双重感染患者的流行特征及治疗情况数据,为贵州省结核病防控措施提供参考依据。方法:通过“中国疾病预防控制信息系统”子系统“结核病信息管理系统”获得贵州省2018—2023年利福平敏感MTB/HIV双重感染患者登记信息,对其流行特征与治疗转归情况进行分析。结果:2018—2023年贵州省利福平敏感MTB/HIV双重感染患者纳入分析共2021例,年龄、性别、民族、职业与MTB/HIV双重感染有关,40~59岁占50.32%(1017/2021),男性占79.76%(1612/2021),汉族占69.12%(1397/2021),农民占77.29%(1562/2021);成功治疗1663例,成功治疗率为82.29%(1663/2021);2021—2023年成功治疗率呈下降趋势(χ_(趋势)^(2)=7.232,P=0.007),治愈所占比例从2021年的48.79%(161/330)增加到2023年的53.20%(183/344),非结核死亡所占比例从2021年的10.61%(35/330)增加到2023年的17.44%(60/344)。多因素logistic回归分析结果显示,与新患者相比,初治失败(OR=5.386,95%CI:1.656~17.516)发生不良结局的风险高;与首次治疗2H-R-Z-E/10H-R-E方案相比,首次治疗2H-R-Z-E/4H-R方案(OR=0.433,95%CI:0.309~0.606)和首次治疗2H-R-Z-E/7~10H-R-E方案(OR=0.497,95%CI:0.302~0.818)发生不良结局的风险均低。结论:2018—2023年贵州省利福平敏感MTB/HIV双重感染患者以40~59岁、男性、汉族、农民为主,治疗期间要注意对机会感染的治疗及并发症的处理,提高治疗过程依从性及按疗程规律治疗,以提高患者成功治疗率。Objective:Analyze characteristics and treatment data of rifampicin sensitive MTB/HIV dual infection patients in Guizhou Province from 2018 to 2023,providing reference basis for optimizing tuberculosis prevention and control measures of Guizhou Province.Methods:The registration information of rifampicin sensitive MTB/HIV dual infection patients in Guizhou Province from 2018 to 2023 was obtained through the“Tuberculosis Information Management System”,a subsystem of the“China Disease Prevention and Control Information System”,and their characteristics and treatment outcomes were analyzed.Results:From 2018 to 2023,there were a total of 2021 rifampicin sensitive MTB/HIV dual infection cases in Guizhou Province.Age,gender,ethnicity,and occupation were related to MTB/HIV dual infection,with 50.32%(1017/2021)cases aged 40-59,79.76%(1612/2021)being male,69.12%(1397/2021)being Han,and 77.29%(1562/2021)being farmers;1663 cases were successfully treated,with an overall success rate of 82.29%(1663/2021).The successful treatment rates of year 2021 to 2023 showed a downward trend(χ_(trend)^(2)=7.232,P=0.007),with the proportion of cured cases increasing from 48.79%(161/330)in 2021 to 53.20%(183/344)in 2023,and the proportion of non-tuberculosis deaths increasing from 10.61%(35/330)in 2021 to 17.44%(60/344)in 2023.The results of multivariable logistic regression analysis showed that compared with new patients,the risk of adverse outcomes was higher for retreatment patients who had experienced a treatment failure previously(OR=5.386,95%CI:1.656-17.516);compared with patients taking 2H-R-Z-E/10H-R-E as primary treatment regime,the risks of adverse outcomes were lower for patients taking 2H-R-Z-E/4H-R(OR=0.433,95%CI:0.309-0.606)and 2H-R-Z-E/7-10H-R-E(OR=0.497,95%CI:0.302-0.818).Conclusion:From 2018 to 2023,the majority of patients with rifampicin sensitive MTB/HIV dual infection in Guizhou Province were male,Han,farmers,and aged 40 to 59.During treatment,attention should be paid to treating opportunistic infections and man

关 键 词：结核 肺 HIV感染 流行病学 治疗结果 

分 类 号：R211[医药卫生—中医学] R183