Email Alert | RSS    帮助

中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (3): 233-239.doi: 10.3969/j.issn.1000-6621.2021.03.008

• 论著 • 上一篇    下一篇

肺结核患者密切接触者12周预防性治疗方案的服药情况及影响因素分析

姚旭, 吴成果, 龚德华, 要玉霞, 张灿有, 徐彩红, 夏愔愔, 陈卉, 成君(), 张慧()   

  1. 102206 北京,中国疾病预防控制中心结核病预防控制中心(姚旭、张灿有、徐彩红、夏愔愔、陈卉、成君、张慧);重庆市结核病防治所区县科(吴成果);湖南省胸科医院防治部(龚德华);河南省疾病预防控制中心结核病控制所(要玉霞)
  • 收稿日期:2020-12-22 出版日期:2021-03-10 发布日期:2021-03-03
  • 通信作者: 成君,张慧 E-mail:chengjun@chinacdc.cn;zhanghui@chinacdc.cn
  • 基金资助:
    “十三五”国家科技重大专项(2017ZX10201302)

Analysis of treatment completeness and its influencing factors of 12-week preventive therapy among close contacts of pulmonary tuberculosis patients

YAO Xu, WU Cheng-guo, GONG De-hua, YAO Yu-xia, ZHANG Can-you, XU Cai-hong, XIA Yin-yin, CHEN Hui, CHENG Jun(), ZHANG Hui()   

  1. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
  • Received:2020-12-22 Online:2021-03-10 Published:2021-03-03
  • Contact: CHENG Jun,ZHANG Hui E-mail:chengjun@chinacdc.cn;zhanghui@chinacdc.cn

摘要:

目的 了解处于结核分枝杆菌潜伏感染状态的肺结核患者密切接触者对12周预防性治疗方案的服药情况及其影响因素。方法 收集2018年8月30日至2020年7月30日“十三五”国家科技重大专项课题(肺结核患者密切接触者潜伏感染干预技术研究)中,经知情同意纳入的989例,年龄5~64周岁应该完成服药的结核分枝杆菌潜伏感染的肺结核患者密切接触者作为研究对象,收集其一般人口学资料、服药记录、不良反应及提前终止服药等信息。采用χ 2检验和多因素logistic回归模型分析影响密切接触者服药情况的因素。结果 989例密切接触者中,有905例完成服药,服药完成率为91.51%。在未完成服药的密切接触者中,中断服药的主要原因是“拒绝继续服药”(41例,48.81%)和“不良反应”(31例,36.90%),中断服药主要发生在服药后的前2个月 (72例,85.71%)。经多因素logistic回归分析显示,年龄为50~64岁者(OR=3.71;95%CI:1.72~8.02)、吸烟者(OR=1.79;95%CI:1.02~3.13)和所在县(区)负责预防性服药的机构为定点医院者(OR=4.51;95%CI:1.91~10.65)更容易发生中断服药。结论 结核分枝杆菌潜伏感染的肺结核患者密切接触者对12周预防性治疗方案的服药完成情况整体较好,但是密切接触者在服药早期易发生中断服药和不良反应,其服药完成率受年龄、吸烟和所在县(区)负责预防性服药的机构影响。

关键词: 结核, 预防和防护用药, 接触者追踪, 因素分析,统计学

Abstract:

Objective To understand the treatment completeness and its influencing factors of 12-weeks’preventive therapy among close contacts of pulmonary tuberculosis (PTB) patients with latent Mycobacterium tuberculosis infection (LTBI). Methods A total of 989 close contacts of PTB patients with LTBI aged 5-64 who should finish their preventive therapy with informed consent were enrolled in the “13th Five-Years Plan” National Science and Technology Major Project-Intervention on latent infected close contacts of TB patients from August 30th, 2018 to July 30th, 2020. General demographic data, medication records, adverse reactions, and reasons of discontinued therapy were collected. Factors influencing the completeness of treatment was analyzed with Chi-square test and multivariate logistic regression model. Results Among 989 close contacts, 905 completed treatment, with a treatment completion rate of 91.51%. Among close contacts who did not complete their treatment, main reasons for discontinued therapy were “refusal to continue treatment” (41 cases, 48.81%) and “adverse reactions” (31 cases, 36.90%). Discontinued therapy mostly occurred in the first 2 months after treatment (72 cases, 85.71%). Multivariate regression showed that aged 50-64 years old (OR=3.71;95%CI:1.72-8.02), smoking (OR=1.79;95%CI:1.02-3.13) and local TB designated hospitals responsible for supervising preventive therapy (OR=4.51;95%CI:1.91-10.65) were risk factors for discontinuing medication. Conclusion Close contacts of PTB patients with LTBI had a high treatment completion rate for the 12-week regimen, but they were likely to discontinue therapy and have adverse reactions at early stage of treatment. Treatment completion rate was affected by age, smoking and institution responsible for supervising preventive treatment in county/district.

Key words: Tuberculosis, Protective agents, Contact tracing, Factor Analysis,statistical