2017-2021年中国9个省份利福平耐药结核病患者不良治疗结局发生情况及影响因素分析  

Analysis on adverse treatment outcome of rifampicin-resistant tuberculosis patients and influencing factors in 9 provinces in China,2017-2021

作　　者：孙慧娟 刘小秋[1] 苏伟[1] 李涛[1] 赵雁林[1] 陈伟[1] Sun Huijuan;Liu Xiaoqiu;Su Wei;Li Tao;Zhao Yanlin;Chen Wei(Department of Policy Planning,National Center for Tuberculosis Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]中国疾病预防控制中心结核病预防控制中心政策规划部,北京102206

出　　处：《中华流行病学杂志》2025年第2期188-195,共8页Chinese Journal of Epidemiology

基　　金：中国疾病预防控制中心科研项目(JY22-3-11);中央财政结核病预防控制项目(2428);国家自然科学基金(12071268)。

摘　　要：目的分析中国9个省份利福平耐药结核病(RR-TB)患者不良治疗结局发生情况及影响因素。方法资料来源于中国疾病预防控制信息系统结核病信息管理系统,收集北京市、吉林省、上海市、江苏省、浙江省、湖北省、河南省、云南省和贵州省共9个省份2017年1月1日至2021年12月31日登记的RR-TB患者的个案信息,包括患者基本信息、诊断情况、治疗情况等,并对人群特征进行描述性分析,采用二元logistic回归分析RR-TB患者发生不良治疗结局的影响因素。结果在登记的18204例RR-TB患者中,发生不良治疗结局的有6852例,不良治疗结局发生率为37.64%。其中治疗失败1031例,死亡1272例,失访2284例,未评估2265例。多因素logistic回归分析结果显示,男性(aOR=1.54,95%CI:1.43~1.66)、年龄≥65岁(aOR=2.42,95%CI:2.20~2.67)、其他民族(aOR=1.18,95%CI:1.03~1.35)、农民(aOR=1.22,95%CI:1.13~1.32)、离/退休人员(aOR=1.16,95%CI:1.00~1.35)、流动人口(aOR=1.23,95%CI:1.13~1.34)、复治(aOR=1.33,95%CI:1.24~1.42)、长程治疗方案(aOR=3.26,95%CI:2.52~4.23)、中部和西部省份(aOR=2.76,95%CI:2.55~2.99;aOR=2.31,95%CI:2.08~2.57)是RR-TB患者发生不良治疗结局的影响因素。结论2017-2021年中国9个省份RR-TB患者不良治疗结局发生率较高。RR-TB患者发生不良治疗结局的影响因素较多,特别是在不同地区间的影响因素存在一定的差异。应加强RR-TB患者中的男性、老年人、流动人口、中西部省份等重点人群的随访与治疗管理,积极推广短程治疗方案,改善医疗资源分配,降低不良治疗结局的发生风险。Objective To analyze the incidence of adverse treatment outcome of rifampicin-resistant tuberculosis(RR-TB)patients and influencing factors in 9 provinces in China.Methods The information about the basic characteristics,diagnosis and treatment of RR-TB patients registered from January 1,2017 to December 31,2021 in 9 provinces(Beijing,Jilin,Shanghai,Jiangsu,Zhejiang,Hubei,Henan,Yunnan and Guizhou)were collected from the tuberculosis information management sub-system of China Disease Control and Prevention Information System for a descriptive analysis,and the influencing factors of adverse treatment outcome were identified by binary logistic regression analysis.Results In 18204 RR-TB patients in this study a total of 6852 had adverse treatment outcomes(37.64%).Treatment failure occurred in 1031 patients,1272 patients died,2284 patients were lost to follow-up,and 2265 patients were not evaluated.The results of multivariate logistic regression analysis showed that being man(aOR=1.54,95%CI:1.43-1.66),age≥65 years(aOR=2.42,95%CI:2.20-2.67),being from other ethnic groups(aOR=1.18,95%CI:1.03-1.35),being farmer(aOR=1.22,95%CI:1.13-1.32),being retired with honours or being retired(aOR=1.16,95%CI:1.00-1.35)and being floating population(aOR=1.23,95%CI:1.13-1.34),re-treatment(aOR=1.33,95%CI:1.24-1.42),long-term treatment therapy(aOR=3.26,95%CI:2.52-4.23),living in central provinces(aOR=2.76,95%CI:2.55-2.99),living in western provinces(aOR=2.31,95%CI:2.08-2.57)were the influencing factors for adverse treatment outcome of RR-TB.Conclusions The incidence of adverse outcomes in RR-TB patients in 9 provinces in China was higher from 2017 to 2021.There were many influencing factors associated with adverse treatment outcome in RR-TB patients,especially the area specific factors.The national tuberculosis control program should strengthen the follow-up and treatment management of RR-TB in men,the elderly,floating population,people in central and western provinces and other key groups,actively promote the short-term treatment program

关 键 词：肺 结核 利福平耐药 治疗结果 影响因素 

分 类 号：R52[医药卫生—内科学]