摘要
目的 探索影响耐多药肺结核(MDR-PTB)患者治疗3个月末痰菌阴转的危险因素。方法收集安徽省胸科医院2020年4月至2021年5月期间住院的249例MDR-PTB患者资料,按照治疗3个月末痰菌是否阴转分为两组:阴性组、阳性组。采用χ2检验进行组间比较分析影响患者3个月末痰菌阴转的因素,针对相关影响因素进行多因素logistic回归分析筛选出独立危险因素。结果 年龄、学历分布、体质量指数(BMI)、治疗类型、二线药物使用情况、耐药类型、合并症、胸部CT表现等是MDR-PTB患者3个月末痰菌阴转的影响因素。其中学历在小学及以下(OR=3.963,95%CI:1.110~14.145,P <0.05)、BMI <18.5 kg/m2(OR=2.682,95%CI:1.255~5.730,P <0.05)、合并糖尿病(OR=2.433,95%CI:1.118~5.296,P <0.05)、CT显示毁损肺(OR=3.634,95%CI:1.684~7.839,P <0.01)等因素是独立危险因素。结论 影响MDR-PTB患者3个月末痰菌阴转的因素较多,其中学历偏低、低体质量、合并糖尿病、伴有毁损肺等是高危因素。临床工作中警惕上述危险因素有助于早期识别可能出现不良预后的患者,给予提早干预、改善疗效。
Objective The aim of this study was to explore the risk factors of sputum culture conversion in patients with multidrug resistant pulmonary tuberculosis(MDR-PTB)at the end of the third month during treatment.Methods A total of 249 MDR-PTB patients in Anhui Chest Hospital from April 2020 to May 2021 were enrolled,and they were divided into negative group or positive group according to sputum culture conversion at the end of the third month.The chi-square test was used to compare the factors affecting the sputum culture conversion between the two groups and multivariate logistic regression analysis was conducted to screen independent risk factors.Results The age,educational background,BMI,the treatment type,the use of second-line drugs,drugresistance type,complications and CT manifestations were influencing factors of sputum culture conversion in MDR-PTB patients at the end of the third month during treatment.Moreover,the education level in primary school and below(OR=3.963,95%CI:1.110~14.145,P<0.05),BMI<18.5 kg/m2(OR=2.682,95%CI:1.255~5.730,P<0.05),diabetes mellitus(OR=2.433,95%CI:1.118~5.296,P<0.05)and lung damage(OR=3.634,95%CI:1.684~7.839,P<0.01)were the independent risk factors.ConclusionThere were many factors affecting the sputum culture conversion in MDR-PTB patients at the end of the third month during treatment,among which low education level,low weight,diabetes and lung damage were high-risk factors.Being alert to the risk factors in the clinical work might be helpful for early identification of patients with poor prognosis and could give early intervention thus improve efficacy.
作者
谢磊
梁雅雪
熊延军
王华
XIE Lei;LIANG Yaxue;XIONG Yanjun;WANG Hua(Anhui Chest Hospital,Clinical College of Chest,Anhui Medical University,Hefei 230022,China)
出处
《实用医学杂志》
CAS
北大核心
2022年第6期701-706,共6页
The Journal of Practical Medicine
基金
“十三五”国家“艾滋病和病毒性肝炎等重大传染病防治”专项课题(编号:2018ZX10302302-001-007)。
关键词
耐多药肺结核
痰菌阴转
危险因素
multidrug-resistant pulmonary tuberculosis
sputum culture conversion
risk factors