Abstract:

Objective To Analysis of chemotherapy efficacy and its influencing factors of multi-drug resistant pulmonary tuberculosis patients.Methods Two hundred and sixty-senven patients with MDR-PTB of Hunan Chest Hospital were collected who conformed China Global Fund TB Program Inclusion Requirements Confirmed. The patients were adopted multi-drug resistant tuberculosis standardized chemotherapy(6Z-Km(Am,Cm)-Lfx(Mfx)-Cs(PAS,E)-Pto/18-Z-Lfx(Mfx)-Cs(PAS,E)-Pto) and individualized chemotherapy to treat. Treatment effect (including healing, completion of treatment, death, failure, loss and other) and influencing factors (Including gender, age, occupation, registration classification, drug resistance, history of previous anti-tuberculosis drug treatment, treatment options, complications, adverse drug reactions, and the medication was regular or not) of 267 patients were analyzed. Univariate analysis using χ ² test and multivariate analysis using binary logistic regression analysis, P<0.05 was considered statistically significant. Results The therapeutic effect of 267 patients with MDR-PTB included 138 cases cured (51.7%), 13 cases completed course of treatment (4.9%), 10 cases deaths (3.7%), 23 cases failed (8.6%), loss of 78 cases (29.2%) and other 5 cases (1.9%). Single factor analysis of affecting the cure rate showed treatment programs (individualized program: 38.0% (27/71), standard chemotherapy program: 56.6% (111/196)), complication (appeared 39.7%(27/68), not appeared 55.8%(111/199)), medical side effects (appeared 31.1%(32/103), not appeared 64.6%(106/164)), taking medicine regularly or not ( regular 94.9%(129/136); not regular 6.9%(9/131)). The four factors was a related factor affecting the treatment effect. (χ ²=7.224,P=0.007;χ ²=5.243,P=0.022;χ ²=28.545,P=0.000;χ ²=206.846,P=0.000). Conclusion Multivariate regression analysis showed that regular medication (Wald χ ²=84.656,P=0.000;OR(95%CI)=229.019(71.974-728.737)) was a protective factor for successful treatment of multidrug-resistant tuberculosis patients. Complication (Wald χ ²=9.652,P=0.002;OR(95%CI)=0.138(0.040-0.482)) and medical side effects (Wald χ ²=5.317,P=0.021;OR(95%CI)=0.313(0.117-0.840)) were risk factor for successful treatment of multidrug-resistant tuberculosis patients.

Key words: Tuberculosis, lung, Tuberculosis, multidrug resistance, Results and process evaluation (health care), Factor analysis, statistics