Analysis of the quality of life and its influencing factors in patients with multidrug-resistant tuberculosis

doi:10.3969/j.issn.1000-6621.2019.01.018

Abstract

Abstract:

Objective To understand the life quality of patients with multidrug-resistant tuberculosis and analyze its influencing factors.Methods A total of 46 patients with multidrug-resistant pulmonary tuberculosis who were registered for the Tuberculosis Management Information System in Yunnan Province from 2012 to 2015 were collected (referred to as “MDR-TB group”). A 1∶1matched case-control study was performed in 46 patients with tuberculosis who were sensitive to the treatment during the period. A cross-sectional study was carried with Quality of Life Instruments for Chronic Disease-Pulmonary Tuberculosis in two groups. And the quality of life of the two groups was measured and compared, and multiple linear regression analysis was used to analyze the factors affecting the quality of life of patients with MDR-TB.Results The total quality of life score, physiological function score, psychological function score, social function score were (152.11±17.04), (35.85±5.53), (39.65±6.84), (29.52±4.92) points in MDR-TB group respectively compared with (169.28±24.05), (41.39±5.53), (44.59±6.24), (32.91±5.66) scores in control group, (t values were 3.95, 4.81, 3.62, and 3.07, respectively, and the P values were <0.05), scores in control group were lower, the difference was statistically significant. Multiple linear regression analysis showed that the influencing factor of quality of life in patients with MDR-TB was correlated with the duration of treatment (β=15.17, t=2.28, P=0.028). Forty-six patients with MDR-TB had a life quality score of (139.33±12.86) for pre-treatment, a score of (151.75±16.56) for treatment, and a score of (169.67±17.67) after treatment. The quality of life of MDR-TB patients increases with the treatment time.Conclusion The quality of life of MDR-TB patients is lower than that of tuberculosis patients who are sensitive to anti-tuberculosis drugs. The duration of treatment is a possible influencing factor in the quality of life of MDR-TB patients.

Key words: Tuberculosis, pulmonary, Tuberculosis, multidrug-resistant, Quality of life, Sickness impact profile, Factor analysis, statistical

Yu-jie ZHAO,Kai YAN,Jin-ou CHEN,Ling LI,Yun-bin YANG,Lin XU. Analysis of the quality of life and its influencing factors in patients with multidrug-resistant tuberculosis[J]. Chinese Journal of Antituberculosis, 2019, 41(1): 88-94. doi: 10.3969/j.issn.1000-6621.2019.01.018

Figures/Tables 5

量表模块	MDR-TB组(46例) (分, $x ˉ$ ±s)	对照组(46例) (分, $x ˉ$ ±s)	t值	P值
生理功能	35.85±5.53	41.39±5.53	4.81	<0.001
心理功能	39.65±6.84	44.59±6.24	3.62	<0.001
社会功能	29.52±4.92	32.91±5.66	3.07	0.003
特异模块	47.09±6.12	50.39±9.61	1.97	0.052
总分	152.11±17.04	169.28±24.05	3.95	<0.001

因素	生命质量总得分(分, $x ˉ$ ±s)	统计检验值	P值
性别		t=-1.17	0.248
男	150.76±17.05
女	158.50±16.54
年龄(岁)		F=0.04	0.988
<20	151.33±33.55
20~	151.67±15.20
40~	153.43±18.57
60~	150.00±16.97
民族		t=2.09	0.042
汉族	154.78±17.50
其他民族	142.50±11.43
学历		t=0.14	0.933
小学	152.80±11.29
初中	151.42±20.34
高中或中专	150.00±19.74
大专及以上	155.25±13.22
职业		F=0.32	0.728
工人	161.00±9.90
农民	152.35±18.15
其他(个体户、待业等)	150.78±16.35
户口所在地		t=0.13	0.901
城市	152.86±10.43
农村	151.97±18.07
家庭月收入(元)		F=0.63	0.602
<1000	149.45±12.61
1000~	154.77±20.62
3000~	147.40±13.79
5000~	158.00±11.79
医保		t=-0.88	0.521
有	153.13±17.51
无	147.25±14.66
是否有药物不良反应		t=0.43	0.670
无	153.35±18.41
有	151.15±16.22
是否规律服药		t=0.94	0.352
是	152.61±17.26
否	141.00±1.41
吸烟量		t=0.32	0.753
不吸烟	152.36±17.20
<1包/d	149.50±17.41
饮酒量		t=-0.24	0.809
不饮酒	151.98±17.20
<100ml/d	155.00±18.38
因素	生命质量总得分(分, $x ˉ$ ±s)	统计检验值	P值
锻炼情况		F=0.70	0.502
不锻炼	146.22±14.59
每周1~3次	153.93±18.26
每周≥4次	151.86±14.63
BMI (kg/m²)		F=0.88	0.421
偏瘦(<18.5)	147.93±14.89
正常(18.5~24)	155.12±18.70
超重及肥胖(≥24)	150.00±14.56
血尿酸^a		t=-0.43	0.668
不正常	152.65±15.87
正常	149.89±22.22
血尿素氮^b		t=-0.55	0.589
不正常	157.33±21.13
正常	151.74±16.97
血清肌酐^c		t=-0.14	0.890
不正常	153.25±9.00
正常	152.00±17.68
天门冬氨酸氨基转移酶^d		t=-0.52	0.606
不正常	154.45±18.05
正常	151.37±16.92
丙氨酸氨基转移酶^e		t=-0.44	0.215
不正常	144.00±10.83
正常	153.33±17.56
白细胞计数^f		F=0.22	0.803
偏低	155.50±9.19
正常	152.58±18.40
偏高	148.00±8.15
血红蛋白^g		t=0.03	0.976
不正常	152.23±14.38
正常	152.06±18.19
红细胞计数^h		F=1.68	0.198
偏低	149.00±26.87
正常	154.09±17.64
偏高	142.13±8.69
治疗持续时间		F=2.62	0.084
治疗前(0个月)	139.33±12.86
治疗中(1~23个月)	151.75±16.56
结束治疗(24个月)	169.67±17.67

变量	β值	s $x ˉ$ 值	r值	t值	P值
常数项	121.78	13.52	-	9.00	<0.001
治疗持续时间	15.17	6.65	0.33	2.28	0.028

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变量	赋值方法
X₁ 性别	男=1,女=2
X₂ 年龄(岁)	0~=1,20~=2,40~=3,60~=4
X₃ 民族	汉族=1,其他民族=2
X₄ 学历	小学=1,初中=2,高中或中专=3,大专及以上=4
X₅ 职业	工人=1,农民=2,其他(个体户、待业等)=3
X₆ 户口所在地	城市=1,农村=2
X₇ 家庭月收入	1000元以下=1,1000~3000元=2,3000~5000元=3,5000元以上=4
X₈ 有无医保	自费=1,有医保=2
X₉ 吸烟情况	不吸烟=1,每天1包以下=2
X₁₀ 饮酒情况	不饮酒=1,每天100ml以下=2
X₁₁ 锻炼情况	不锻炼=1,每周锻炼1~3次=2,每周锻炼4次及以上=3
X₁₂ 药物不良反应	无=1,有=2
X₁₃ 规律服药	是=1,否=2
X₁₄ BMI (kg/m²)	BMI<18.5=1,18.5≤BMI<24=2,BMI≥24=3
X₁₅ 血尿酸	男性:237.9μmol/L~356.9μmol/L=1;>356.9μmol/L=2 女性:178.4μmol/L~297.4μmol/L=1;>297.4μmol/L=2
X₁₆ 血尿素氮	<7.1mmol/L=1, ≥7.1mmol/L=2
X₁₇ 血清肌酐	男性:<106μmol/L=1,>106μmol/L=2 女性:<96μmol/L=1,>96μmol/L=2
X₁₈ 天门冬氨酸氨基转移酶	≤40U/L=1,>40U/L=2
X₁₉ 丙氨酸氨基转移酶	≤40U/L=1,>40U/L=2
X₂₀ 白细胞计数	<4×10⁹/L=1, 4×10⁹/L~10×10⁹/L=2,>10×10⁹/L=3
X₂₁ 血红蛋白	男性:<120g/L=1,120g/L~160g/L=2,>160g/L=3 女性:<110g/L=1,110g/L~150g/L=2,>150g/L=3
X₂₂ 红细胞计数	男性:<4×10¹²/L=1, 4×10¹²/L~5.5×10¹²/L=2,>5.5×10¹²/L=3 女性:<3.5×10¹²/L=1, 3.5×10¹²/L~5.0×10¹²/L=2,>5.0×10¹²/L=3
X₂₃ 治疗持续时间	0个月=1,1~23个月=2, 24个月=3