Email Alert | RSS    帮助

中国防痨杂志 ›› 2013, Vol. 35 ›› Issue (5): 357-360.

• 论著 • 上一篇    下一篇

757例初治肺结核患者抗结核治疗效果影响因素分析

陈红光 王春霞 刘海涛 刘民   

  1. 100191 北京大学公共卫生学院流行病与卫生统计学系（陈红光、刘民）；江苏省响水县疾病预防控制中心慢性传染病防治科（王春霞、刘海涛）
  • 收稿日期:2012-07-13 出版日期:2013-05-10 发布日期:2013-07-02
  • 通信作者: 刘民 E-mail:liumin@bjmu.edu.cn

Risk factors analysis on anti-TB treatment outcomes of 757 primary pulmonary tuberculosis cases

CHEN Hong-guang, WANG Chun-xia, LIU Hai-tao, LIU Min   

  1. Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, 100191,China
  • Received:2012-07-13 Online:2013-05-10 Published:2013-07-02
  • Contact: LIU Min E-mail:liumin@bjmu.edu.cn

PDF (PC)

522

摘要： 目的  了解初治肺结核的治疗动态并探讨影响其治疗效果的因素。 方法  以2009—2011年江苏省响水县疾病预防控制中心登记并随访管理的757例初治结核病患者作为研究对象，采用同时考虑事件结局、随访时间及截尾数据的生存分析模型进行单因素和多因素分析。 结果  757例患者中成功治疗720例，不良结果37例。Kaplan-Meier生存率曲线估计初治肺结核中位成功治疗时间为182 d，Log-rank单因素分析结果显示来源为转诊、因症就诊及其他途径患者的实际成功治疗数所占比例分别为24.17% (174/720)，66.53% (479/720)，9.31% (67/720)，与各来源估计成功治疗比例分别为29.86%（215/720），59.72%（430/720），10.42%（75/720）之间分布差异具有统计学意义(χ2=23.19，P =0.000)。存在延迟与未存在延迟就诊患者的实际成功治疗数所占比例分别为26.67% (192/720)与73.33% (528/720)，与延迟与否估计成功治疗比例 (31.25%，68.75%)之间分布差异具有统计学意义(χ2=11.33，P=0.001)；Cox多因素分析显示45～岁（OR=1.213，95%CI=1.014～1.452）及≥60岁以上（OR=1.323，95%CI=1.069～1.636）年龄组的成功治疗率高于30岁以下，农民（OR=0.787，95%CI=0.650～0.953）及其他职业者(OR=0.755，95%CI=0.591～0.966)成功治疗率低于工人，因症就诊（OR=1.498，95%CI=1.275～1.760）的成功治疗率高于转诊患者，延迟就诊（OR=0.782，95%CI=0.658～0.929）的成功治疗率低于非延迟者。 结论  在当地肺结核初治过程中，应加强对农民、30岁以下年龄段、转诊来源及存在延迟就诊的患者的治疗管理。

关键词: 结核,肺/治疗, 治疗结果, 存活率分析

Abstract: Objective  To explore the treatment dynamics and risk factors on treatment outcomes of pulmonary tuberculosis. Methods  Seven hundred and fifty-seven cases of primary pulmonary tuberculosis registered and followed up in Xiangshui county from 2009 to 2011 was analyzed by univariate and multivariate based on survival analysis model. Results  Of 757 patients, 720 cases were successfully treated. Median healing time of pulmonary tuberculosis was 182 days estimated by Kaplan-Meier survival curves. Univariate analysis on risk factor showed that the proportion of the observed numbers under successful treatment from detection were 24.17% (174/720)，66.53% (479/720)，9.31% (67/720) respectively. Compared to the proportion of the expected numbers under successful treatment (29.86%, 59.72%, 10.42%), the distribution difference was statistically significant (χ2=23.19, P=0.000). The proportion of the observed numbers under successful treatment from delayed diagnosis status were 26.67% (192/720) and 73.33% (528/720). Compared to the proportion of the expected numbers under successful treatment(31.25%，68.75%), the distribution difference was statistically significant (χ2=11.33, P=0.001). Cox multivariate analysis showed that factors with age under 30，（45－＜60，OR=1.213, 95%CI=1.014-1.452; ≥60（OR=1.323, 95%CI=1.069-1.636), being farmers(OR=0.787, 95%CI=0.650-0.953) and others (OR=0.755, 95%CI=0.591-0.966), with case detection by referring way(OR=1.498，95%CI=1.275-1.760), delayed diagnosis(OR=0.782，95%CI=0.658-0.929) affected the cure rate of pulmonary tuberculosis.  Conclusion  More attention should be paid to TB cases being farmers, with age under 30, detected by referring way and having delayed diagnosis.

Key words: Tuberculosis,pulmonary/therapy, Treatment outcome, Survival analysis

版权所有 © 2021 中国防痨协会　　　京ICP备11029069号-1   京公网安备11010202007215号
ip访问总数:  ip当日访问总数:  当前在线人数:
本作品遵循Creative Commons Attribution 3.0 License授权许可