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中国防痨杂志 ›› 2022, Vol. 44 ›› Issue (12): 1303-1313.doi: 10.19982/j.issn.1000-6621.20220212

• 论著 • 上一篇    下一篇


李硕兰1,2, 李明武2(), 李光妹2, 汪林2, 万荣2, 马萌2   

  1. 1大理大学公共卫生学院,大理 671000
    2昆明市第三人民医院结核二科,昆明 650041
  • 收稿日期:2022-06-06 出版日期:2022-12-10 发布日期:2022-12-02
  • 通信作者: 李明武

Influencing factors of getting unfavorable treatment outcomes of patients with multidrug-resistant pulmonary tuberculosis in China: a Meta-analysis

Li Shuolan1,2, Li Mingwu2(), Li Guangmei2, Wang Lin2, Wan Rong2, Ma Meng2   

  1. 1College of Public Health, Dali University, Dali 671000
    2The Second Department of Tuberculosis, the Third People’s Hospital of Kunming, Kunming 650041, China
  • Received:2022-06-06 Online:2022-12-10 Published:2022-12-02
  • Contact: Li Mingwu


目的: 评价耐多药肺结核(multidrug-resistant pulmonary tuberculosis,MDR-PTB)治疗转归的影响因素。 方法: 通过计算机检索中文数据库(中国知网、万方数据库、中文科技期刊数据库、中国生物医学文献数据库)和英文数据库(PubMed、Embase、Web of Science),搜集有关中国MDR-PTB治疗转归影响因素的研究,检索时限均从建库至2021年12月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。 结果: 共纳入21项研究,包含4663例患者。Meta分析结果显示:在多因素分析中,复治(OR=2.63,95%CI:1.54~4.47)、合并症(OR=4.28,95%CI:2.61~7.03)、不良反应(OR=2.71,95%CI:1.87~3.93)、空洞(OR=2.79,95%CI:1.82~4.28)、不合理化疗(OR=5.80,95%CI:2.05~16.41)、不规范治疗(OR=6.05,95%CI:1.91~19.18)均与MDR-PTB治疗转归相关。 结论: 临床相关因素中的复治、合并症、不良反应、空洞、不合理化疗和不规范治疗是我国MDR-PTB患者发生不良转归的危险因素,对于存在危险因素的患者需要加强管理,警惕不良反应的发生,降低MDR-PTB治疗失败率。

关键词: 结核, 抗多种药物性, 治疗结果, 危险因素, Meta分析


Objective: To systematically review the influencing factors of unfavorable treatment outcomes of multidrug-resistant pulmonary tuberculosis (MDR-PTB) in China. Methods: Chinese databases (CNKI, WanFang Data, VIP, CBM) and English databases (PubMed, Embase, Web of Science) were electronically searched to collect studies about factors of unfavorable treatment outcomes of MDR-PTB. The time was limited as from inception of those databases to December 2021. Two researchers independently screened literatures, extracted information and evaluated the risk of bias. RevMan 5.3 was used to conduct Meta-analysis. Results: A total of 21 studies involving 4663 patients were included. Meta-analysis results showed that re-treatment (OR=2.63, 95%CI:1.54-4.47), complications (OR=4.28, 95%CI:2.61-7.03), adverse reactions (OR=2.71, 95%CI:1.87-3.93), cavity (OR=2.79, 95%CI:1.82-4.28), unreasonable chemotherapy (OR=5.80, 95%CI:2.05-16.41) and irregular treatment (OR=6.05, 95%CI:1.91-19.18) were associated with MDR-PTB treatment outcomes in multivariable analysis. Conclusion: The existing evidence suggested that re-treatment, complications, cavity, adverse reactions, unreasonable chemotherapy as well as irregular treatment were risk factors for unfavorable outcomes of MDR-PTB. In order to reduce the failure rate of MDR-PTB treatment, patients with these risk factors should receive strengthened medical managements and be cautious about the occurrence of adverse reactions.

Key words: Tuberculosis, multidrug-resistant, Treatment outcome, Risk factors, Meta-analysis