摘要
目的 探讨流动人口中涂阳肺结核患者治疗失败的影响因素，为制定干预措施、改善治疗效果提供理论依据。方法 以深圳市宝安区2008年1月1日至2012年12月31日完成治疗疗程且转归为失败或治愈的流动涂阳肺结核患者为研究对象。纳入的研究对象4398例，治愈患者4007例，治疗失败者391例。运用χ2检验、Kruskal-Wallis 检验或Fisher 精确检验比较治疗失败与治愈患者在人口学特征、临床特征、检验结果、管理方式等方面的差异，检验水准为0.05，同时采用非条件logistic回归分析探讨治疗失败的影响因素。结果 治疗失败患者中男性占72.63%（284/391），明显高于治愈患者的比率［62.27%（2495/4007）］，两组间差异有统计学意义（χ2=16.4636，P〈0.0001）；治疗失败患者中30岁以下人群占40.66%（159/391），明显低于治愈患者的比率［56.68%（2271/4007）］，两组间差异有统计学意义（χ2=36.9359，P〈0.0001）；治疗失败患者中2个月末痰检结果阳性者占48.69%（186/382），明显高于治愈患者的比率［14.08%（562/3992）］，两组间差异有统计学意义（χ2=294.6323，P〈0.0001）；治疗失败患者中，实行系统管理的比例为94.37%（369/391），低于治愈患者的比例98.65%（3953/4007），两组间差异有统计学意义（χ2=38.4086，P〈0.0001）；治疗失败患者中有空洞者占48.59%（190/391）明显高于治愈患者（36.41%，1459/4007），两组间差异有统计学意义（χ2=22.5579，P〈0.0001）。多因素非条件logistic回归结果显示，女性、30岁及以上、2个月末痰检阳性、实行系统管理和有空洞与治疗失败显著相关，OR值（95%CI值）分别为0.76（0.60-0.97）、1.59（1.27-1.99）、5.13（4.10-6.43）、0.37（0.19-0.72）和1.36（1.09-1.70）。结论 女性、实行系统管理是治疗失败的保护因素, 30岁及以上、2个月末痰检阳性和有空洞是治疗失败的危险因素�
Objective To explore the risk factors associated with treatment failure in smear positive pulmo-nary tuberculosis （PTB） patients among floating population, and to provide a theoretical evidence for intervention measures development. Methods 4398 smear positive PTB patients among floating population that completed the treatment course with an outcome of failure or cure from January 2008 to December 2012 in Bao＇an district, Shen-zhen city were enrolled in this study, among whom 4007 were cured and 391 were failed. The demographic, clinical, bacteriological information and management methods were compared by Chi-square test, Kruskal-Wallis test or Fisher＇s test, and non-conditional logistic regression analysis was used to explore the influencing factors for treatment failure. Results There were more males in treatment failure group （72.63%, 284/391） than cure group （62.27%, 2495/4007）, and the difference was statistically significant（χ2=16.4636,P〈0.0001）. Compared to cure group （56.66%,2271/4007）, less cases were younger than 30 years in failure group （40.66%,159/391）, and there was significant difference between the 2 groups （χ2=36.9359, P〈0.0001）. More patients in failure group had positive sputum at the end of 2 months＇ treatment （48.69%, 186/382） than cure group （14.08%, 562/3992）, and the difference was statistically significant （χ2=294.6323, P〈0.0001）. The proportion of patients treated with systematic management was 94.37% （369/391） in failure group, which was significantly lower than cure group （98.65%, 3953/4007） （χ2=38.4086, P〈0.0001）. Cavity presented more in failure group （48.59%, 190/391） than cure group （36.41%, 1459/4007）, and the difference was statistically significant （χ2=22.5579, P〈0.0001）. The result of unconditional logistic regression analysis showed that female, aged 30 years and above, smear-positive at the end of 2 months＇ treatment, the implementation of the systematic management and presence of cavity
出处
《中国防痨杂志》
CAS
2013年第11期900-904,共5页
Chinese Journal of Antituberculosis
基金
"十二五"国家科技重大专项(2012ZX10004-903)
关键词
结核
肺
治疗
治疗失败
危险因素
深圳市
Tuberculosis, pulmonary/therapy
Treatment failure
Risk factors
Shenzhen city
