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中国防痨杂志 ›› 2019, Vol. 41 ›› Issue (12): 1301-1309.doi: 10.3969/j.issn.1000-6621.2019.12.011

• 论著 • 上一篇    下一篇

中国耐多药结核病发病危险因素的Meta分析

许金红*,杨松,张立新,钟颖,邱倩()   

  1. 重庆市公共卫生医疗救治中心结核病研究室(杨松、邱倩)
  • 收稿日期:2019-07-04 出版日期:2019-12-10 发布日期:2019-12-13
  • 通信作者: 邱倩 E-mail:qiuqian120@126.com
  • 基金资助:
    重庆市自然科学基金面上项目(cstc2019jcyj-msxmX0028);重庆市科卫联合医学科研项目青年项目(2019QNXM038);重庆市公共卫生医疗救治中心青年科研创新基金(2019QNKYXM01)

Risk factors of multidrug-resistant tuberculosis in China: A meta-analysis

Jin-hong XU*,Song YANG,Li-xin ZHANG,Ying ZHONG,Qian QIU()   

  1. Department of Oncology, Tongren People’s Hospital Guizhou Province, Tongren 554300, China
  • Received:2019-07-04 Online:2019-12-10 Published:2019-12-13
  • Contact: Qian QIU E-mail:qiuqian120@126.com

摘要:

目的 系统评价中国发生耐多药结核病(MDR-TB)的主要危险因素并进行分析,为我国提供有效预防MDR-TB的措施,达到病因预防(一级预防)的目的。方法 时间限定为2005年1月至2019年5月,在英文数据库(PubMed、Embase、Web of Science、Cochrane Library)和中文数据库(中国知网、万方、中国生物医学文献服务系统与维普)检索中国耐多药结核病发病危险因素的相关论文,经过对论文的筛选、提取资料和质量评价后进行Meta分析。结果 根据检索结果、入选及排除标准,共纳入55篇论文,通过Meta分析,发现MDR-TB相关的危险因素有9种。结果显示外省户籍人口(OR=1.92;95%CI=1.48~2.51)、家庭收入低下(OR=2.12;95%CI=1.72~2.63)、患者分类为复治患者(OR=6.28;95%CI=4.72~8.36)、既往有抗结核药物治疗史(OR=5.73;95%CI=4.56~7.20)、既往抗结核药物治疗史次数≥2次(OR=4.41;95%CI=3.35~5.80)、药物不良反应(OR=4.89;95%CI=2.48~9.62)、中断治疗(OR=3.59;95%CI=2.02~6.38)、肺部空洞(OR=1.56;95%CI=1.25~1.93)和吸烟(OR=1.59;95%CI=1.12~2.25)与MDR-TB的发病密切相关。结论 中国MDR-TB的发病危险因素可能为外地人口、家庭收入低下、复治患者、既往抗结核治疗史、既往抗结核治疗史次数≥2次、药物不良反应、中断治疗、肺部空洞和吸烟史。

关键词: 中国, 结核,抗多种药物性, 危险因素, Meta分析(主题)

Abstract:

Objective This study systematically evaluated the risk factors for multidrug-resistant tuberculosis (MDR-TB) in China, which could provide an effective prevention and control strategy, and achieve the purpose of cause prevention (primary prevention).Methods The articles related to the risk factors of MDR-TB which published from January, 2005 to May, 2019 were searched in English databases (PubMed, Embase, Web of Science, Cochrane Library) and Chinese databases (China National Knowledge Internet, Wanfang, SinoMed and VIP database), and then meta-analysis was performed following the screening, extracting data and quality evaluation of the articles.Results According to the search results and inclusion and exclusion criteria, a total of 55 articles were included, and 9 risk factors related to MDR-TB were found by meta-analysis. The results showed that the migrant population (OR=1.92; 95%CI=1.48-2.51), low household income (OR=2.12; 95%CI=1.72-2.63), re-treatment (OR=6.28; 95%CI=4.72-8.36), anti-tuberculosis treatment history (OR=5.73; 95%CI=4.56-7.20), anti-tuberculosis treatment history ≥2 times (OR=4.41; 95%CI=3.35-5.80), adverse drug reactions (OR=4.89; 95%CI=2.48-9.62), treatment interruption (OR=3.59; 95%CI=2.02-6.38), lung cavity (OR=1.56; 95%CI=1.25-1.93) and smoking (OR=1.59; 95%CI=1.12-2.25) were closely related to the pathogenesis of MDR-TB.Conclusion The risk factors for MDR-TB in China are possibly migrant population, low household income, re-treatment, anti-tuberculosis treatment history, anti-tuberculosis treatment history ≥2 times, adverse reactions, treatment interruption, lung cavities and smoking.

Key words: China, Tuberculosis,multidrug-resistant, Risk factors, Meta-analysis as topic