387名结核分枝杆菌潜伏感染者预防性治疗服药完成情况及影响因素分析

doi:10.19982/j.issn.1000-6621.20240230

中国防痨杂志 ›› 2024, Vol. 46 ›› Issue (12): 1496-1503.doi: 10.19982/j.issn.1000-6621.20240230

387名结核分枝杆菌潜伏感染者预防性治疗服药完成情况及影响因素分析

加依那提·金格斯¹, 王新旗²^,³, 刘年强¹, 王森路¹^,²(), 依帕尔·艾海提²(), 冯建宇⁴, 黄涛¹, 克地尔叶克孜·吾甫尔¹

¹新疆医科大学公共卫生学院,乌鲁木齐 830017
²新疆维吾尔自治区疾病预防控制中心结核病/麻风病防治中心,乌鲁木齐 830002
³巴音郭楞蒙古自治州疾病预防控制中心结核病防治科,库尔勒 841499
⁴阿克苏地区疾病预防控制中心结核病防治科,阿克苏 843000

收稿日期:2024-06-06 出版日期:2024-12-10 发布日期:2024-12-03
通信作者: 王森路,Email:27788599@qq.com;依帕尔·艾海提,Email:121025832@qq.com
基金资助:
“天山英才”医药卫生高层次人才培养计划(TSYC202301B166);新疆维吾尔自治区自然科学基金(2023D01C57);公共卫生人才培养项目(01063局)

Analysis of treatment completeness and its influencing factors of preventive treatment among 387 latent tuberculosis infection cases

Jiayinati Jingesi¹, Wang Xinqi²^,³, Liu Nianqiang¹, Wang Senlu¹^,²(), Yipaer Aihaiti²(), Feng Jianyu⁴, Huang Tao¹, Kedieryekezi Wufuer¹

¹School of Public Health, Xinjiang Medical University, Urumqi 830017, China
²Tuberculosis/Leprosy Control Center, Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi 830002, China
³Department of Tuberculosis Prevention and Control, Center for Disease Control and Prevention of Bayinguoleng Mongolia Autonomous Prefecture, Korla 841499, China
⁴Department of Tuberculosis Prevention and Control, Aksu Regional Center for Disease Control and Prevention, Aksu 843000, China

Received:2024-06-06 Online:2024-12-10 Published:2024-12-03
Contact: Wang Senlu, Email: 27788599@qq.com; Yipaer Aihaiti, Email: 121025832@qq.com
Supported by:
“Tianshan Talents” Medical and Health High-level Talent Training Program(TSYC202301B166);Natural Science Foundation of Xinjiang Uygur Autonomous Region(2023D01C57);Public Health Talent Training Project(01063JU)

摘要/Abstract

摘要：

目的: 研究肺结核患者密切接触者中的结核分枝杆菌潜伏感染(latent tuberculosis infection, LTBI)者对3个月每周服用2次异烟肼和利福喷丁联合间歇(3H-P)预防性治疗方案的服药完成情况及影响服药完成的因素,为进一步推广预防性治疗措施提供参考依据。方法: 收集2023年1月1日至12月31日期间,新疆维吾尔自治区(简称“新疆”)阿克苏地区乌什县经知情同意纳入的387名与肺结核患者密切接触的接受预防性治疗的LTBI者作为研究对象。通过问卷调查,了解预防性治疗服药完成情况及其影响因素。问卷主要内容包括基本人口学信息、结核病防治核心知识知晓情况及预防性治疗服药情况等。采用单因素和多因素logistic回归分析与预防性服药完成情况相关的影响因素。结果: 387名LTBI者中,有355名完成3H-P方案服药,服药完成率为91.73%;不良反应发生率为14.21%(55/387),因不良反应停药率为4.39%(17/387)。多因素logistic回归分析结果显示,规律运动(OR=5.337,95%CI:2.309~12.337)、参与结核病防治相关培训(OR=4.406,95%CI:1.942~9.994)是肺结核患者密切接触者中的LTBI者完成服药的保护因素;有饮酒史(OR=0.279,95%CI:0.108~0.720)、年龄在50~64岁(OR=0.254,95%CI:0.092~0.698)是肺结核患者密切接触者中的LTBI者中断服药的危险因素。结论: 肺结核患者密切接触者中的LTBI者预防性治疗的服药完成情况总体良好,不良反应为中断服药的原因之一,服药完成率还会受到未规律运动、有饮酒史、未参与过结核病防治相关培训、年龄50~64岁等因素的影响。

关键词: 结核, 肺, 接触者追踪, 抗结核药, 预防和防护用药, 因素分析, 统计学

Abstract:

Objective: To study the treatment completeness and its influencing factors of 3H-P preventive treatment among close contacts of tuberculosis patients with latent tuberculosis infection (LTBI) and to provide a reference for further promotion of preventive treatment. Methods: Between January 1, 2023 and December 31, 2023, 387 LTBI cases who had close contact with tuberculosis patients and received preventive treatment with informed consent from Wushi County, Aksu Prefecture, Xinjiang Uygur Autonomous Region (Xinjiang) were enrolled as research subjects. A questionnaire was used to collect information of the completion of preventive treatment and its influencing factors, mainly including basic demographic information, awareness of tuberculosis prevention and control core knowledge, completion of preventive treatment, etc. Univariable and multivariable logistic regression were used to analyze the influencing factors related to the completion of preventive treatment. Results: Among 387 LTBI cases, 355 completed preventive treatment, with a treatment completion rate of 91.73%. The incidence of adverse reactions was 14.21% (55/387), and 4.39% (17/387) of cases discontinued their treatment due to adverse reactions. Multivariable logistic regression analysis indicated that taking exercise regularly (OR=5.337, 95%CI: 2.309-12.337) and attending training on tuberculosis prevention and control (OR=4.406, 95%CI: 1.942-9.994) were protective factors for completion of preventive treatment, while a history of alcohol consumption (OR=0.279, 95%CI: 0.108-0.720) and aged 50-64 years (OR=0.254, 95%CI: 0.092-0.698) were risk factors for completion of treatment. Conclusion: Completion of preventive treatment among close contacts of tuberculosis patients with LTBI was generally good, with adverse reactions being one of the main reasons for interruption of treatment. The completion rate of their treatment was affected by not exercising regularly, history of alcohol consumption, not attending training on tuberculosis prevention and control, and aged 50-64 years.

Key words: Tuberculosis, pulmonary, Contact tracing, Antitubercular agents, Protective agents, Factor analysis, statistical

中图分类号:

R521

加依那提·金格斯, 王新旗, 刘年强, 王森路, 依帕尔·艾海提, 冯建宇, 黄涛, 克地尔叶克孜·吾甫尔. 387名结核分枝杆菌潜伏感染者预防性治疗服药完成情况及影响因素分析[J]. 中国防痨杂志, 2024, 46(12): 1496-1503. doi: 10.19982/j.issn.1000-6621.20240230

Jiayinati Jingesi, Wang Xinqi, Liu Nianqiang, Wang Senlu, Yipaer Aihaiti, Feng Jianyu, Huang Tao, Kedieryekezi Wufuer. Analysis of treatment completeness and its influencing factors of preventive treatment among 387 latent tuberculosis infection cases[J]. Chinese Journal of Antituberculosis, 2024, 46(12): 1496-1503. doi: 10.19982/j.issn.1000-6621.20240230

图/表 4

表1

表2

表3

表4

387名结核分枝杆菌潜伏感染者对3H-P预防性治疗方案完成情况影响因素的多因素logistic回归分析

变量	β值	s $x ˉ$ 值	Wald χ²值	P值	OR值	95%CI值
规律运动
是	1.675	0.427	15.347	0.000	5.337	2.309~12.337
否	-	-	-	1.000	-	-
饮酒史
有	-1.276	0.484	6.960	0.008	0.279	0.108~0.720
无	-	-	-	1.000	-	-
参加过结核病防治相关培训
是	1.483	0.418	12.592	0.000	4.406	1.942~9.994
否	-	-	-	1.000	-	-
年龄组(岁)
5~17	-0.498	0.766	0.423	0.515	0.607	0.135~2.728
18~34	-0.368	0.881	0.174	0.676	0.692	0.123~3.892
35~49	0.054	0.765	0.005	0.943	1.056	0.236~4.726
50~64	-1.372	0.517	7.053	0.008	0.254	0.092~0.698
≥65	-	-	-	1.000	-	-

表4

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特征	服药人数(名)	构成比(%)
性别
男性	178	45.99
女性	209	54.01
年龄组(岁)
5~17	44	11.37
18~34	35	9.04
35~49	62	16.02
50~64	112	28.94
≥65	134	34.63
婚姻状况
已婚	268	69.25
未婚/离婚/丧偶	119	30.75
教育程度
初中及以下	309	79.84
高中及以上	78	20.16
家庭年收入(万元)
<3	197	50.90
≥3	190	49.10
合并慢性病
是	220	56.85
否	167	43.15
接种卡介苗
是	264	68.22
否	123	31.78
饮酒史
有	46	11.89
无	341	88.11
规律运动
是	289	74.68
否	98	25.32
吸烟史
有	71	18.35
无	316	81.65
参加过结核病防治相关培训
是	280	72.35
否	107	27.65
家庭住址与当地定点医院距离(km)
<3	228	58.91
≥3	159	41.09
结核病防治核心知识知晓情况
良好	341	88.11
较差	46	11.89
密切接触者与肺结核患者的关系
家庭内	232	59.95
家庭外	155	40.05

因素		服药人数(名)		完成服药人数(名)	服药完成率(%)	χ²值	P值
性别						0.071	0.790
男性		178		164	92.13
女性		209		191	91.39
年龄组(岁)						10.073	0.039
5~17		44		41	93.18
18~34		35		33	94.29
35~49		62		59	95.16
50~64		112		95	84.82
≥65		134		127	94.78
婚姻状况						0.542	0.462
已婚		268		244	91.04
未婚/离婚/丧偶		119		111	93.28
教育程度						0.445	0.505
初中及以下		309		282	91.26
高中及以上		78		73	93.59
年收入(万元)						0.069	0.793
<3		197		180	91.37
≥3		190		175	92.11
合并慢性病						0.197	0.657
是		220		203	92.27
否		167		152	91.02
接种卡介苗						0.005	0.946
是		264		242	91.67
否		123		113	91.87
饮酒史						8.783	0.003
有		46		37	80.43
无		341		318	93.26
规律运动						14.259	0.000
是		289		274	94.81
否		98		81	82.65
吸烟史						0.290	0.590
有	71		64		90.14
无	316		291		92.09
参加过结核病防治相关培训						11.319	0.001
是	280		265		94.64
否	107		90		84.11
家庭住址与当地定点医院距离(km)						0.649	0.420
<3	228		207		90.79
≥3	159		148		93.08
结核病防治核心知识知晓情况						1.058	0.304
良好	341		311		91.20
较差	46		44		95. 65
密切接触者与肺结核患者的关系						2.067	0.151
家庭内	232		209		90.09
家庭外	155		146		94.19

变量名称	赋值情况	变量名称	赋值情况
完成服药	否=0,是=1	参加过结核病防治相关培训	否=0,是=1
规律运动	否=0,是=1	年龄(岁)	5~17=1; 18~34=2; 35~49=3; 50~64=4;≥65= 0
饮酒史	无=0,有=1	年龄(岁)	5~17=1; 18~34=2; 35~49=3; 50~64=4;≥65= 0

387名结核分枝杆菌潜伏感染者预防性治疗服药完成情况及影响因素分析

Analysis of treatment completeness and its influencing factors of preventive treatment among 387 latent tuberculosis infection cases

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