摘要
目的 了解利福平耐药肺结核患者确诊延迟和治疗延迟情况,分析其影响因素,为今后改进我国耐药结核病防控措施,提高耐药结核病诊疗质量提供参考。方法 采用“十三五”全国结核病防治规划终期评估中“肺结核患者诊疗现况调查”专题调查数据,提取人口学特征、经济情况、临床特征、就诊情况、治疗情况等信息,对于利福平耐药肺结核患者确诊延迟和治疗延迟进行描述性分析,采用χ^(2)检验和多因素logistic回归分析其影响因素。结果 152例利福平耐药肺结核患者中,确诊天数中位数(四分位数)[M(P_(25),P_(75))]为53(14,161)d,确诊延迟率为75.00%(114/152);确诊到治疗天数M(P_(25),P_(75))为3(0,18)d,治疗延迟率为38.82%(59/152)。确诊延迟患者中男性占71.93%(82/114),年龄45~<65岁占42.98%(49/114),初中文化程度占34.21%(39/114),已婚占64.04%(73/114),本县区户籍占64.91%(74/114),农民占29.82%(34/114);治疗延迟患者中男性占62.71%(37/59),45~<65岁占45.76%(27/59),初中文化程度占30.51%(18/59),已婚占62.71%(37/59),本县区户籍占67.80%(40/59),农民占30.51%(18/59)。多因素logistic回归分析结果显示,分子生物学检查无结果和阴性(OR=4.024,95%CI:1.289~12.565)、就诊次数>2次(OR=3.015,95%CI:1.277~7.120)是确诊延迟的危险因素,就诊次数>2次(OR=3.205,95%CI:1.536~6.688)是治疗延迟的危险因素。结论 利福平耐药肺结核患者确诊延迟率和治疗延迟率处于较高水平,今后应提高医疗机构新技术诊断能力,加强结核病诊疗机构能力建设,减少患者就诊次数,以改善患者确诊延迟、治疗延迟情况。
Objective To understand the status of delay in diagnosis and treatment of rifampicin-resistant tuberculosis, analyze the influencing factors, and provide the reference for improving the prevention and control measures and the quality of diagnosis and treatment of drug-resistant tuberculosis in the future. Methods Data were sourced from the special-topic survey“Current Status Of Diagnosis and Treatment of Pulmonary Tuberculosis Patients”in the final evaluation of the 13th Five-Year Tuberculosis Prevention and Control Plan, and the information including demographic characteristics, economic status, clinical characteristics, medical treatment situation and treatment situation was extracted. The diagnosis delay and treatment delay were descriptively analyzed. Chi-square test and multivariate logistic regression were used to analyze the influencing factors. Results Of the 152 patients with rifampicin-resistant pulmonary tuberculosis, the median number of days delayed diagnosis was 53(14,161) days, and the diagnosis delay rate was 75.00%(114/152). The median number of days from diagnosis to treatment was 3(0, 18)days, and the treatment delay rate was 38.82%(59/152). Of the patients with diagnosis delay, 71.93%(82/114) were male;45-<65years old accounted for 42.98%(49/114);junior high school education level accounted for 34.21%(39/114);64.04%(73/114)were married;64.91%(74/114) were registered in the county or district;farmers accounted for 29.82%(34/114). Of the patients with treatment delay, 62.71%(37/59) were male;45-<65 years old accounted for 45.76%(27/59);junior high school education level accounted for 30.51%(18/59);62.71%(37/59) were married;household registration in the county accounted for 67.80%(40/59);farmers accounted for 30.51%(18/59). Multivariate logistic regression analysis results showed that no or negative molecular biology results(OR=4.024, 95%CI:1.289-12.565), the number of seeing doctor>2(OR=3.015, 95%CI: 1.277-7.120)were risk factors for diagnosis delay. The number of seeing doctor >2(OR =3.205
作者
王涵飞
徐彩红
WANG Hanfei;XU Caihong(National Center for Tuberculosis Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)
出处
《现代疾病预防控制》
2024年第5期355-359,共5页
MODERN DISEASE CONTROL AND PREVENTION
基金
中央财政结核病控制项目结核业务日常运转(232811)。
关键词
利福平耐药肺结核
确诊延迟
治疗延迟
Rifampicin-resistant pulmonary tuberculosis
Diagnosis delay
Treatment delay
