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中国防痨杂志 ›› 2023, Vol. 45 ›› Issue (10): 981-988.doi: 10.19982/j.issn.1000-6621.20230187

• 论著 • 上一篇    下一篇

2019—2022年山东省潍坊市肺结核患者强化期痰涂片未转阴的影响因素分析

张博1, 李丽1, 郑丽娟2, 刘学法1()   

  1. 1山东省潍坊市第二人民医院公共卫生科,潍坊 261000
    2山东省潍坊市第二人民医院儿科,潍坊 261000
  • 收稿日期:2023-06-02 出版日期:2023-10-10 发布日期:2023-10-07
  • 通信作者: 刘学法,Email:tb370700@163.com

Risk factors of delayed sputum smear conversion in pulmonary tuberculosis patients after intensive treatment in Weifang City Shandong Province from 2019 to 2022

Zhang Bo1, Li Li1, Zheng Lijuan2, Liu Xuefa1()   

  1. 1Department of Public Health, Weifang Second People's Hospital, Shangdong Province, Weifang 261000, China
    2Department of Pediatrics, Weifang Second People's Hospital, Shangdong Province, Weifang 261000, China
  • Received:2023-06-02 Online:2023-10-10 Published:2023-10-07
  • Contact: Liu Xuefa,Email:tb370700@163.com

摘要:

目的: 分析肺结核患者强化期治疗后,痰菌未转阴的影响因素,为促进痰菌转阴、改善治疗效果提供科学依据。方法: 通过“中国疾病预防控制信息系统”子系统“结核病管理信息系统”收集2019年1月1日至2022年12月31日山东省潍坊市第二人民医院登记报告的病原学阳性患者,经纳入、排除标准,共455例肺结核患者纳入研究。收集年龄、性别、身高、体质量、糖尿病史等基本信息。采用SPSS 20.0软件对数据进行分析,通过logistic回归分析探讨涂阳肺结核患者涂片未转阴的影响因素。结果: 经过强化期治疗,有299例患者涂片转阴,156例患者持续涂阳,转阴率为65.7%。logistic回归分析显示,糖尿病[OR(95%CI)=1.859(1.096~3.153)]、并发症[OR(95%CI)=1.855(1.117~3.082)]、痰液菌量++++[OR(95%CI)=3.529(1.063~11.715)]、低蛋白血症[OR(95%CI)=1.749(1.040~2.943)]、贫血[OR(95%CI)=2.398(1.412~4.070)]与涂阳肺结核患者痰涂片转阴失败相关。结论: 肺结核患者伴有糖尿病、并发症、痰液菌量++++、低蛋白血症、贫血会增加强化期痰涂片转阴失败的风险。及时识别、发现、纠正此类危险因素,有助于患者痰菌转阴,降低传播风险,避免不良预后的发生。

关键词: 结核,肺, 痰, 因素分析,统计学

Abstract:

Objective: To analyze the influencing factors of delayed sputum smear conversion after intensive treatment of pulmonary tuberculosis patients, and provide scientific evidence for promoting sputum conversion and improving treatment effectiveness. Methods: Through the TB Information Management System of the Chinese Disease Prevention and Control Information System, information of etiologically positive patients registered and reported in Weifang Second People's Hospital of Shandong Province from January 1, 2019 to December 31, 2022 were collected. With inclusion and exclusion criteria, a total of 455 patients with tuberculosis were included in the study. Basic information such as age, gender, height, weight, and diabetes history was collected. Data analysis were conducted using SPSS 20.0 software. Logistic regression analysis was used to investigate the factors that influenced delayed sputum smear conversion. Results: After receiving intensive treatment, 299 patients showed negative results in their sputum tests, while 156 patients still tested positive. The rate of sputum bacteria turning negative was 65.7%. Logistic regression analysis indicated that certain factors were associated with delayed conversion, including diabetes (OR (95%CI)=1.859 (1.096-3.153)), complications (OR (95%CI)=1.855 (1.117-3.082)), sputum bacillary load being ++++ (OR (95%CI)=3.529 (1.063-11.715)), hypoproteinemia (OR (95%CI)=1.749 (1.040-2.943)), and anemia (OR (95%CI)=2.398 (1.412-4.070)). Conclusion: Patients with tuberculosis who also have diabetes, complications, sputum bacillary load being ++++, hypoalbuminemia, and anemia are at a higher risk for delayed sputum smear conversion. Identifying and correcting these risk factors timely can help patients achieve sputum negative conversion, reduce the risk of transmission, and prevent adverse prognosis.

Key words: Tuberculosis, pulmonary, Sputum, Factor analysis, statistical

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