敏感肺结核患者强化期痰培养延迟阴转的危险因素分析  

Analysis of risk factors for delayed negative conversion of sputum culture during intensive phase in patients with sensitive pulmonary tuberculosis

作　　者：史珂[1] 代金芳 李强[2] Shi Ke;Dai Jinfang;Li Qiang(Department of Tuberculosis Three Wards,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang Henan 453100,China;Department of Tuberculosis,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]新乡医学院第一附属医院结核内科三病区,河南新乡453100 [2]首都医科大学附属北京胸科医院结核内科,北京101149

出　　处：《遵义医科大学学报》2025年第3期274-279,285,共7页Journal of Zunyi Medical University

基　　金：北京市通州区第三批“两高”人才项目(NO:YHLJ202005)。

摘　　要：目的 探讨影响敏感肺TB患者强化期痰培养阴转延迟的危险因素。方法 纳入自2020年6月至2024年6月在北京胸科医院经痰液培养确诊的肺TB患者567例,根据2月末时痰培养阴转情况分为阴转组和未阴转组,采用Logistic回归模型分析患者强化期痰培养延迟阴转的危险因素。结果 强化期结束时痰培养转阴组423例(74.6%),未阴转组144例(25.4%),多因素Logistic回归分析结果显示,年龄≥60岁[OR(95%CI):3.092(2.383~4.947),P=0.029]、男性[3.062(1.717~5.460),P<0.001]、有吸烟史[1.904(1.071~3.386),P=0.028]、有饮酒史[1.934(1.095~3.416),P=0.023]、合并糖尿病[2.585(1.587~4.209),P<0.001]、肺部空洞≥2个[2.543(1.497~4.321),P=0.001]、累及肺野数≥4个[3.880(1.614~9.326),P=0.002]是强化期痰培养阴转延迟的危险因素。结论 临床上,对于具备以上危险因素的患者,采取相应措施进行干预,可适当延长强化期治疗时间。Objective To explore the risk factors affecting the delayed negative conversion of sputum culture in patients with sensitive pulmonary tuberculosis(TB)during the intensive phase.Methods 567 pulmonary TB patients diagnosed through sputum culture at Beijing Chest Hospital from June 2020 to June 2024 were included.They were divided into two groups based on the negative conversion of sputum culture at the end of the intensive phase:the negative conversion group and the non-negative conversion group.Logistic regression analysis was used to analyze the risk factors for delayed negative conversion of sputum culture during the intensive phase in patients.Results At the end of the intensive phase,there were 423 cases(74.6%)in the negative conversion group and 144 cases(25.4%)in the non-negative conversion group.Multivariate logistic regression analysis showed that age≥60 years[OR(95%CI):3.092(2.383-4.947),P=0.029],male[3.062(1.717-5.460),P<0.001],smoking history[1.904(1.071-3.386),P=0.028],drinking history[1.934(1.095-3.416),P=0.023],diabetes[2.585(1.587-4.209),P<0.001],pulmonary cavity≥2[2.543(1.497-4.321),P=0.001],and affected lung fields≥4[3.880(1.614-9.326),P=0.002]were the risk factors for delayed negative conversion of sputum culture in intensive stage.Conclusion In clinic,corresponding measures should be taken to intervene in patients with the above risk factors,and the duration of intensive treatment can be appropriately extended.

关 键 词：肺结核 强化期 培养 危险因素 

分 类 号：R521[医药卫生—内科学]