老年药物敏感肺结核临床特征及影响治疗转归因素分析

doi:10.19982/j.issn.1000-6621.20260078

中国防痨杂志 ›› 2026, Vol. 48 ›› Issue (9): 1266-1276.doi: 10.19982/j.issn.1000-6621.20260078

老年药物敏感肺结核临床特征及影响治疗转归因素分析

白燕¹^,², 陈禹³, 高绪胜⁴, 梁建琴⁵, 曾谊⁶, 王芸¹(), 范琳¹^,²()

¹ 贵州医科大学公共卫生与健康学院, 环境污染与疾病监控教育部重点实验室, 贵阳 561113
² 同济大学附属上海市肺科医院结核科, 上海市感染性疾病临床研究中心(结核病),上海市结核(肺)重点实验室, 上海 200433
³ 沈阳市第十人民医院结核科, 沈阳 110044
⁴ 山东省公共卫生临床中心结核科, 济南 250102
⁵ 中国人民解放军总医院第八医学中心结核科, 北京 100091
⁶ 南京市第二医院结核科, 南京 211131

收稿日期:2026-02-05 出版日期:2026-09-10 发布日期:2026-09-08
通信作者: 王芸,范琳 E-mail:fanlinsj@163.com;441334899@qq.com
基金资助:
国家自然科学基金(82170006);上海市肺科医院临床研究项目(SKPY2021003);国家重点研发计划(2025YFE0205900)

Analysis of clinical characteristics and factors influencing outcomes in elderly patients with drug-susceptible pulmonary tuberculosis

Bai Yan¹^,², Chen Yu³, Gao Xusheng⁴, Liang Jianqin⁵, Zeng Yi⁶, Wang Yun¹(), Fan Lin¹^,²()

¹ School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 561113, China
² Department of Tuberculosis, Shanghai Pulmonary Hospital Affiliated to Tongji University/Shanghai Tuberculosis Clinical Research Center/Shanghai Key Laboratory of Tuberculosis (Lung), Shanghai 200433, China
³ Department of Tuberculosis, Shenyang Tenth People’s Hospital, Shenyang 110044, China
⁴ Department of Tuberculosis, Shandong Provincial Public Health Clinical Center, Jinan 250102, China
⁵ Department of Tuberculosis, The Eighth Medical Center of Chinese PLA General Hospital, Beijing 100091, China
⁶ Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing 211131, China

Received:2026-02-05 Online:2026-09-10 Published:2026-09-08
Contact: Wang Yun,Fan Lin E-mail:fanlinsj@163.com;441334899@qq.com
Supported by:
National Natural Science Foundation of China(82170006);Clinical Research Program of Shanghai Pulmonary Hospital(SKPY2021003);National Key Research and Development Program of China(2025YFE0205900)

摘要/Abstract

摘要：

目的: 分析老年药物敏感肺结核(drug-susceptible pulmonary tuberculosis, DS-PTB)患者临床特征及治疗转归的影响因素,为改善老年DS-PTB患者的预后提供研究证据。 方法: 采用全国多中心、回顾性队列研究方法,纳入2020年1月1日至2025年1月31日期间全国5家医院收治的≥60岁老年DS-PTB患者2349例,收集患者全疗程的临床特征及治疗转归结果,并采用多因素logistic回归模型分析患者治疗转归的临床影响因素。 结果: 2349例患者的成功治疗率为69.26%(1627/2349),其中,治愈率为40.95%(962/2349),完成治疗率为28.31%(665/2349),治疗失败率为26.39%(620/2349),失访率为3.36%(79/2349),病死率为0.98%(23/2349)。多因素logistic回归分析显示,复治(OR=1.352, 95%CI:1.037~1.764)、营养不良(OR=2.657, 95%CI:1.588~4.444)、病灶累及3个及以上肺野(OR=1.776, 95%CI:1.425~2.213)及肺部空洞(OR=1.436, 95%CI:1.173~1.757)、药物不良反应(OR=4.005, 95%CI:3.284~4.884)均是老年DS-PTB患者治疗转归的危险因素;疗程延长(OR=0.937, 95%CI:0.913~0.962)和治疗方案使用9H-Rpt-E-Lfx(OR=0.649, 95%CI:0.498~0.846)均是治疗转归的保护因素。 结论: 老年DS-PTB患者治疗成功率偏低,临床实践中应重视复治、营养不良、病灶广泛伴空洞形成及对药物耐受性差的患者群体,对以上因素早期干预,以改善老年患者预后。

关键词: 结核,肺, 治疗结果, 老年人, 因素分析,统计学

Abstract:

Objective: To investigate clinical characteristics and identify clinical determinants of treatment outcomes in elderly patients with drug-susceptible pulmonary tuberculosis (DS-PTB), with the aim of providing evidence to improve prognosis. Methods: A national multicenter retrospective cohort study was conducted, enrolling 2349 elderly DS-PTB patients aged ≥60 years admitted to five hospitals between January 1, 2020 and January 31, 2025. Clinical information throughout the entire treatment course and treatment outcome data were collected. Multivariate logistic regression models were employed to analyze clinical factors influencing treatment outcomes in these patients. Results: The successful treatment rate among the 2349 patients was 69.26% (1627/2349), comprising a cure rate of 40.95% (962/2349) and a treatment completion rate of 28.31% (665/2349). Treatment failure in 26.39% (620/2349), lost to follow-up in 3.36% (79/2349), and death in 0.98% (23/2349). Multivariate logistic regression analysis showed that retreatment (OR=1.352, 95%CI:1.037-1.764), malnutrition (OR=2.657, 95%CI: 1.588-4.444), involvement of three or more lung fields (OR=1.776, 95%CI:1.425-2.213), pulmonary cavitation (OR=1.436, 95%CI:1.173-1.757), and adverse drug reactions (OR=4.005, 95%CI:3.284-4.884) were identified as risk factors for unfavorable treatment outcomes in elderly patients with DS-PTB. Prolonged treatment duration (OR=0.937, 95%CI:0.913-0.962) and use of the 9H-Rpt-E-Lfx regimen (OR=0.649, 95%CI:0.498-0.846) emerged as protective factors associated with favorable treatment outcomes. Conclusion: Elderly DS-PTB patients showed a lower successful treatment rate. In clinical practice, priority attention should be given to patients with retreatment, malnutrition, extensive lesions with cavitation, and poor drug tolerance, and early intervention targeting these factors is helpful to improve prognosis in this population.

Key words: Tuberculosis, pulmonary, Treatment outcome, Aged, Factor analysis, statistical

中图分类号:

R521

白燕, 陈禹, 高绪胜, 梁建琴, 曾谊, 王芸, 范琳. 老年药物敏感肺结核临床特征及影响治疗转归因素分析[J]. 中国防痨杂志, 2026, 48(9): 1266-1276. doi: 10.19982/j.issn.1000-6621.20260078

Bai Yan, Chen Yu, Gao Xusheng, Liang Jianqin, Zeng Yi, Wang Yun, Fan Lin. Analysis of clinical characteristics and factors influencing outcomes in elderly patients with drug-susceptible pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2026, 48(9): 1266-1276. doi: 10.19982/j.issn.1000-6621.20260078

图/表 8

表1

表2

表3

老年药物敏感肺结核患者治疗转归影响因素的单因素分析

因素	例数	成功治疗组 (1627例)	不良治疗转归组 (722例)	χ²值	P值
性别[例(构成比,%)]				0.989	0.320
女性	591	419(70.90)	172(29.10)
男性	1758	1208(68.71)	550(31.29)
年龄组[例(构成比,%)]				2.993	0.559
60~64岁	515	371(72.04)	144(27.96)
65~69岁	705	486(68.94)	219(31.06)
70~74岁	503	347(68.99)	156(31.01)
75~79岁	309	206(66.67)	103(33.33)
≥80岁	317	217(68.45)	100(31.55)
治疗类型[例(构成比,%)]				8.182	0.004
初治	2015	1418(70.37)	597(29.63)
复治	334	209(62.57)	125(37.43)
治疗方案[例(构成比,%)]				34.397	<0.001
2H-R-Z-E/4H-R	1022	699(68.40)	323(31.60)
9H-Rpt-E-Lfx	539	410(76.07)	129(23.93)
2H-Rpt-Z-E/4H-Rpt	282	210(74.47)	72(25.53)
9H-R-E-Lfx	347	218(62.82)	129(37.18)
其他^a	159	90(56.60)	69(43.40)
并发结核性胸膜炎[例(构成比,%)]				0.019	0.891
是	296	204(68.92)	92(31.08)
否	2053	1423(69.31)	630(30.69)
并发支气管结核[例(构成比,%)]				7.410	0.007
是	187	146(78.07)	41(21.93)
否	2162	1481(68.50)	681(31.50)
并发肺外结核[例(构成比,%)]				0.011	0.917
是	390	271(69.49)	119(30.51)
否	1959	1356(69.22)	603(30.78)
并发糖尿病[例(构成比,%)]				0.285	0.593
是	701	491(70.04)	210(29.96)
否	1648	1136(68.93)	512(31.07)
并发心脏疾病[例(构成比,%)]				0.226	0.635
是	320	218(68.13)	102(31.88)
否	2029	1409(69.44)	620(30.56)
并发脑血管疾病[例(构成比,%)]				0.742	0.389
是	213	142(66.67)	71(33.33)
否	2136	1485(69.52)	651(30.48)
并发恶性肿瘤[例(构成比,%)]				1.751	0.186
是	152	98(64.47)	54(35.53)
否	2197	1529(69.59)	668(30.41)
并发免疫性疾病[例(构成比,%)]				<0.001	0.989
是	75	52(69.33)	23(30.67)
否	2274	1575(69.26)	699(30.74)
并发慢性肺病[例(构成比,%)]				0.176	0.675
是	270	190(70.37)	80(29.63)
否	2079	1437(69.12)	642(30.88)
并发慢性肝病[例(构成比,%)]				0.364	0.546
是	291	206(70.79)	85(29.21)
否	2058	1421(69.05)	637(30.95)
并发慢性肾病[例(构成比,%)]				0.802	0.371
是	180	130(72.22)	50(27.78)
否	2169	1497(69.02)	672(30.98)
并发营养不良[例(构成比,%)]				20.840	<0.001
是	75	34(45.33)	41(54.67)
否	2274	1593(70.05)	681(29.95)
并发呼吸衰竭[例(构成比,%)]				3.969	0.046
是	32	17(53.12)	15(46.88)
否	2317	1610(69.49)	707(30.51)
肺部病灶范围[例(构成比,%)]				48.433	<0.001
<3个	1525	982(64.39)	543(35.61)
≥3个	824	645(78.28)	179(21.72)
出现空洞[例(构成比,%)]				25.616	<0.001
是	1066	682(63.98)	384(36.02)
否	1283	945(73.66)	338(26.34)
药物不良反应[例(构成比,%)]				190.153	<0.001
是	766	386(50.39)	380(49.61)
否	1583	1241(78.40)	342(21.60)
疗程(月)[M(Q₁,Q₃)]^b	-	12(10,14)	11(8,14)	-2.810	0.005

表3

表4

表5

表6

图1

表7

参考文献 39

[1]	屈燕, 李涛, 马文斌, 等. 世界卫生组织《2025年全球结核病报告》解读[J]. 结核与肺部疾病杂志, 2025, 6(6): 613-623. doi:10.19983/j.issn.2096-8493.20250178.
[2]	张梦迪, 王琦琦, 王鑫, 等. 2005-2020年中国60岁及以上老年人群肺结核疾病负担研究[J]. 中国防痨杂志, 2025, 47(3):338-347. doi:10.19982/j.issn.1000-6621.20240508
[3]	Li S, Li Y, Song W, et al. Population aging and trends of pulmonary tuberculosis incidence in the elderly[J]. BMC Infect Dis, 2021, 21(1):302. doi:10.1186/s12879-021-05994-z.
[4]	Jun C, Yan-Ni S, Can-You Z, et al. Incidence and risk factors of tuberculosis among the elderly population in China: a prospective cohort study[J]. Infect Dis Poverty, 2020, 9(1):13. doi:10.1186/s40249-019-0614-9. pmid: 32005290
[5]	滕人聪, 李涛, 李玉红, 等. 2015-2021年全国65岁及以上老年肺结核患者登记情况分析[J]. 中国防痨杂志, 2023, 45(4):367-371. doi:10.19982/j.issn.1000-6621.20220494.
[6]	Luo D, Wang F, Chen S, et al. Age-period-cohort study of active pulmonary tuberculosis in eastern China: analysis of 15-year surveillance data[J]. BMC Public Health, 2025, 25(1):651. doi:10.1186/s12889-025-21770-z. pmid: 39962430
[7]	Singh K P, Carvalho A C C, Centis R, et al. Clinical standards for the management of adverse effects during treatment for TB[J]. Int J Tuberc Lung Dis, 2023, 27(7):506-519. doi:10.5588/ijtld.23.0078. pmid: 37353868
[8]	Saukkonen J J, Duarte R, Munsiff S S, et al. Updates on the Treatment of Drug-Susceptible and Drug-Resistant Tuberculosis: An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline[J]. Am J Respir Crit Care Med, 2025, 211(1):15-33. doi:10.1164/rccm.202410-2096ST.
[9]	World Health Organization. WHO consolidated guidelines on tuberculosis: Module 4: treatment: drug-susceptible tuberculosis treatment[R]. Geneva: World Health Organization, 2022.
[10]	World Health Organization. WHO consolidated guidelines on tuberculosis: Module 3: diagnosis[R]. Geneva: World Health Organization, 2025.
[11]	Linh N N, Viney K, Gegia M, et al. World Health Organization treatment outcome definitions for tuberculosis: 2021 update[J]. Eur Respir J, 2021, 58(2): 2100804. doi:10.1183/13993003.00804-2021.
[12]	World Health Organization. Meeting report of the WHO expert consultation on drug-resistant tuberculosis treatment outcome definitions[R]. Geneva: World Health Organization, 2021.
[13]	World Health Organization. WHO consolidated operational handbook on tuberculosis: Module 4: treatment and care[R]. Geneva: World Health Organization, 2025.
[14]	Tabernero E, Rodrigo T, Garros J, et al. TB in the elderly: clinical features and outcomes[J]. Int J Tuberc Lung Dis, 2022, 26(9):842-849. doi:10.5588/ijtld.22.0010. pmid: 35996280
[15]	Medrano B A, Lee M, Gemeinhardt G, et al. Tuberculosis presentation and outcomes in older Hispanic adults from Tamaulipas, Mexico[J]. Medicine (Baltimore), 2023, 102(41):e35458. doi:10.1097/MD.0000000000035458.
[16]	Hong H Y, Park Y, Yong S H, et al. Risk Factors for Unfavorable Outcomes of Tuberculosis in Korea: Implications for Patient-Centered Care in Tuberculosis Treatment[J]. J Korean Med Sci, 2024, 39(2):e4. doi:10.3346/jkms.2024.39.e4.
[17]	Sinha P, Ponnuraja C, Gupte N, et al. Impact of Undernutrition on Tuberculosis Treatment Outcomes in India: A Multicenter, Prospective, Cohort Analysis[J]. Clin Infect Dis, 2023, 76(8):1483-1491. doi:10.1093/cid/ciac915.
[18]	Nimmo C, Millard J, Faulkner V, et al. Evolution of Mycobacterium tuberculosis drug resistance in the genomic era[J]. Front Cell Infect Microbiol, 2022, 12:954074. doi:10.3389/fcimb.2022.954074.
[19]	Vadakunnel M J, Nehru V J, Brammacharry U, et al. Factors associated with unfavourable treatment outcomes among patients with Multidrug-resistant Tuberculosis receiving outpatients care[J]. Sci Rep, 2025, 15(1):28335. doi:10.1038/s41598-025-13227-5.
[20]	Webber T, Macdonald C, Tameris M, et al. Immune, metabolic, anatomical, and functional features of people after successful tuberculosis treatment: an exploratory analysis[J]. Sci Rep, 2025, 15(1):18392. doi:10.1038/s41598-025-01656-1.
[21]	Carwile M E, Hochberg N S, Sinha P. Undernutrition is feeding the tuberculosis pandemic: A perspective[J]. J Clin Tuberc Other Mycobact Dis, 2022, 27:100311. doi:10.1016/j.jctube.2022.100311.
[22]	Ozer N T, Gundogan K. The Vicious Cycle of Malnutrition and Tuberculosis: A Narrative Review[J]. J Clin Pract Res, 2024, 46(5):444-448. doi:10.14744/cpr.2024.60895.
[23]	Chandrasekaran P, Saravanan N, Bethunaickan R, et al. Malnutrition: Modulator of Immune Responses in Tuberculosis[J]. Front Immunol, 2017, 8:1316. doi:10.3389/fimmu.2017.01316.
[24]	Gomes M, Saad Júnior R, Stirbulov R. Pulmonary tuberculosis: relationship between sputum bacilloscopy and radiological lesions[J]. Rev Inst Med Trop Sao Paulo, 2003, 45(5):275-281. doi:10.1590/s0036-46652003000500007.
[25]	Strydom N, Gupta S V, Fox W S, et al. Tuberculosis drugs’ distribution and emergence of resistance in patient’s lung lesions: A mechanistic model and tool for regimen and dose optimization[J]. PLoS Med, 2019, 16(4):e1002773. doi:10.1371/journal.pmed.1002773.
[26]	Zhang L, Pang Y, Yu X, et al. Risk factors for pulmonary cavitation in tuberculosis patients from China[J]. Emerg Microbes Infect, 2016, 5(10):e110. doi:10.1038/emi.2016.111.
[27]	Li X, Ye J, Wang S, et al. Factors associated with post-treatment resorption of lung cavities in individuals with first episodes of drug-sensitive cavitary pulmonary tuberculosis in China[J]. BMC Infect Dis, 2025, 25(1):899. doi:10.1186/s12879-025-11287-6.
[28]	Ma L, Fan H. Key Factors Influencing Liver Function Injury in Elderly Patients with Newly Diagnosed Pulmonary Tuberculosis Complicated by Diabetes after Antituberculosis Treatment[J]. Am J Trop Med Hyg, 2025, 112(1):135-142. doi:10.4269/ajtmh.24-0248.
[29]	Saito N, Yoshii Y, Kaneko Y, et al. Impact of renal function-based anti-tuberculosis drug dosage adjustment on efficacy and safety outcomes in pulmonary tuberculosis complicated with chronic kidney disease[J]. BMC Infect Dis, 2019, 19(1):374. doi:10.1186/s12879-019-4010-7. pmid: 31046706
[30]	Wu I L, Chitnis A S, Jaganath D. A narrative review of tuberculosis in the United States among persons aged 65 years and older[J]. J Clin Tuberc Other Mycobact Dis, 2022, 28:100321. doi:10.1016/j.jctube.2022.100321.
[31]	Osipov N N, Spelnikov D, Belyaeva E, et al. Drug Resistance and Comorbidities in the Treatment of Pulmonary Tuberculosis: A Multicenter Retrospective Cohort Study[J]. Antibiotics (Basel), 2025, 14(10):986. doi:10.3390/antibiotics14100986.
[32]	Mereškevičienė R, Danila E. The Adverse Effects of Tuberculosis Treatment: A Comprehensive Literature Review[J]. Medicina (Kaunas), 2025, 61(5):911. doi:10.3390/medicina61050911.
[33]	Louie J K, Keh C, Agraz-Lara R, et al. Adverse Events Associated with Treatment for Pan-Susceptible Tuberculosis in San Francisco[J]. Clin Infect Dis, 2023, 76(6):1121-1124. doi:10.1093/cid/ciac867.
[34]	Ngcobo N N. Influence of Ageing on the Pharmacodynamics and Pharmacokinetics of Chronically Administered Medicines in Geriatric Patients: A Review[J]. Clin Pharmacokinet, 2025, 64(3):335-367. doi:10.1007/s40262-024-01466-0. pmid: 39798015
[35]	Hosford J D, von Fricken M E, Lauzardo M, et al. Hepatotoxicity from antituberculous therapy in the elderly: a systematic review[J]. Tuberculosis (Edinb), 2015, 95(2):112-122. doi:10.1016/j.tube.2014.10.006.
[36]	Xu A Y, Velásquez G E, Zhang N, et al. Pyrazinamide Safety, Efficacy, and Dosing for Treating Drug-Susceptible Pulmonary Tuberculosis: A Phase 3, Randomized Controlled Clinical Trial[J]. Am J Respir Crit Care Med, 2024, 210(11):1358-1369. doi:10.1164/rccm.202401-0165OC.
[37]	He Y, Liang L, Wei S. Comparative safety profile of levofloxacin versus moxifloxacin in first-line tuberculosis therapy: a pharmacovigilance study of the FAERS database[J]. Front Pharmacol, 2025, 16:1713170. doi:10.3389/fphar.2025.1713170.
[38]	Liu C, Chen R, Shu C, et al. Prevalence, clinical reasons and associated factors of extended treatment duration for drug susceptible tuberculosis-a real-world experience[J]. Sci Rep, 2025, 15(1):14709. doi:10.1038/s41598-025-97517-y.
[39]	Caraux-Paz P, Diamantis S, de Wazières B, et al. Tuberculosis in the Elderly[J]. J Clin Med, 2021, 10(24): 5888. doi:10.3390/jcm10245888.

方案类型	核心药物组合
治疗方案一	2H-R-Z-E/4H-R(标准治疗方案)
治疗方案二	9H-Rpt-E-Lfx
治疗方案三	2H-Rpt-Z-E/4H-Rpt
治疗方案四	9H-R-E-Lfx

变量	赋值
治疗转归	成功治疗=0,不良治疗转归=1
性别	女性=0,男性=1
年龄	60~64岁=0,65~69岁=1,70~74岁=2,75~79岁=3,≥80岁=4
并发支气管结核	否=0,是=1
并发恶性肿瘤	否=0,是=1
并发营养不良	否=0,是=1
并发呼吸衰竭	否=0,是=1
肺部病灶范围	<3个肺野=0,≥3个肺野=1
肺部空洞	无=0,有=1
治疗类型	初治=0,复治=1
治疗方案(月)	2H-R-Z-E/4H-R=0,9H-Rpt-E-Lfx=1,2H-Rpt-Z-E/4H-Rpt=2,其他=3
药物不良反应	未发生=0,发生=1
治疗疗程(月)	原值代入

因素	β值	s${}_{\overline{\mathit{x}}}$值	P值	OR(95%CI)值
年龄组(60~64岁为参照组)
65~69岁	0.057	0.138	0.677	1.059(0.808~1.387)
70~74岁	0.050	0.150	0.736	1.052(0.784~1.411)
75~79岁	0.248	0.171	0.148	1.281(0.916~1.792)
≥80岁	0.073	0.178	0.681	1.076(0.760~1.524)
并发支气管结核	-0.323	0.202	0.110	0.724(0.488~1.076)
并发恶性肿瘤	0.218	0.194	0.262	1.243(0.850~1.819)
并发营养不良	0.977	0.262	<0.001	2.657(1.588~4.444)
并发呼吸衰竭	0.486	0.390	0.213	1.627(0.757~3.495)
≥3个肺野	0.574	0.112	<0.001	1.776(1.425~2.213)
出现肺部空洞	0.362	0.103	<0.001	1.436(1.173~1.757)
复治	0.302	0.136	0.026	1.352(1.037~1.764)
治疗方案(2H-R-Z-E/4H-R为参照组)
9H-Rpt-E-Lfx	-0.432	0.135	0.001	0.649(0.498~0.846)
2H-Rpt-Z-E/4H-Rpt	-0.272	0.163	0.096	0.762(0.553~1.049)
9H-R-E-Lfx	0.154	0.142	0.277	1.167(0.884~1.540)
其他^a	0.221	0.191	0.247	1.247(0.858~1.813)
发生药物不良反应	1.387	0.101	<0.001	4.005(3.284~4.884)
疗程(月)	-0.065	0.013	<0.001	0.937(0.913~0.962)

治疗方案	分类	60~64岁 (515例)	65~69岁 (705例)	70~74岁 (503例)	75~79岁 (309例)	≥80岁 (317例)	χ²值	P值
2H-R-Z-E/4H-R	方案使用率	55.53(286/515)	49.22(347/705)	42.15(212/503)	33.01(102/309)	23.66(75/317)	104.710	<0.001
	成功治疗率	71.68(205/286)	69.45(241/347)	65.57(139/212)	65.69(67/102)	62.67(47/75)	3.876	0.423
9H-Rpt-E-Lfx	方案使用率	13.79(71/515)	17.59(124/705)	22.27(112/503)	30.42(94/309)	43.53(138/317)	121.770	<0.001
	成功治疗率	81.69(58/71)	70.16(87/124)	82.14(92/112)	74.47(70/94)	74.64(103/138)	6.167	0.187
2H-Rpt-Z-E/4H-Rpt	方案使用率	10.10(52/515)	10.78(76/705)	12.92(65/503)	13.59(42/309)	14.83(47/317)	6.302	0.178
	成功治疗率	80.77(42/52)	72.37(55/76)	76.92(50/65)	66.67(28/42)	74.47(35/47)	2.813	0.590
9H-R-E-Lfx	方案使用率	13.79(71/515)	16.03(113/705)	15.90(80/503)	14.89(46/309)	11.67(37/317)	4.217	0.378
	成功治疗率	60.56(43/71)	69.91(79/113)	60.00(48/80)	56.52(26/46)	59.46(22/37)	3.821	0.431
其他^a	方案使用率	6.80(35/515)	6.38(45/705)	6.76(34/503)	8.09(25/309)	6.31(20/317)	1.129	0.890
	成功治疗率	65.71(23/35)	53.33(24/45)	52.94(18/34)	60.00(15/25)	50.00(10/20)	2.037	0.729

因素	复治	治疗方案[n/、2H-R-Z-E/4H-R为参照组]
因素	复治	9H-Rpt-E-Lfx	2H-Rpt-Z-E/4H-Rpt	9H-R-ELfx	其他^a
主效应分析	1.352(1.037~1.764)	0.649(0.498~0.846)	0.762(0.553~1.049)	1.167(0.884~1.540)	1.247(0.858~1.813)
剔除单位1	1.367(1.008~1.855)	0.852(0.617~1.176)	0.812(0.552~1.194)	1.052(0.752~1.472)	1.259(0.814~1.945)
剔除单位2	1.476(1.069~2.039)	0.633(0.447~0.896)	0.880(0.592~1.306)	1.262(0.869~1.832)	1.470(0.879~2.460)
剔除单位3	1.372(1.043~1.804)	0.676(0.517~0.886)	0.723(0.518~1.009)	1.142(0.859~1.518)	1.224(0.833~1.799)
剔除单位4	1.260(0.950~1.670)	0.621(0.471~0.820)	0.787(0.566~1.093)	1.154(0.866~1.539)	1.103(0.749~1.625)
剔除单位5	1.232(0.893~1.700)	0.585(0.435~0.788)	0.681(0.471~0.986)	1.304(0.964~1.764)	1.350(0.897~2.031)

老年药物敏感肺结核临床特征及影响治疗转归因素分析

Analysis of clinical characteristics and factors influencing outcomes in elderly patients with drug-susceptible pulmonary tuberculosis

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特征	例数	构成比(%)
性别
男性	1758	74.84
女性	591	25.16
年龄组(岁)
60~64	515	21.92
65~69	705	30.01
70~74	503	21.41
75~79	309	13.15
≥80	317	13.50
治疗类型
初治	2015	85.78
复治	334	14.22
治疗方案
2H-R-Z-E/4H-R	1022	43.51
9H-Rpt-E-Lfx	539	22.95
2H-Rpt-Z-E/4H-Rpt	282	12.01
9H-R-E-Lfx	347	14.77
其他^a	159	6.77
并发结核性胸膜炎	296	12.60
并发支气管结核	187	7.96
并发肺外结核	390	16.60
并发糖尿病	701	29.84
并发心脏疾病	320	13.62
并发脑血管疾病	213	9.07
并发恶性肿瘤	152	6.47
并发免疫性疾病	75	3.19
并发慢性肺病	270	11.49
并发慢性肝病	291	12.39
并发慢性肾病	180	7.66
并发营养不良	75	3.19
并发呼吸衰竭	32	1.36
肺部病灶范围(个)
<3	1525	64.92
≥3	824	35.08
空洞
有	1066	45.38
无	1283	54.62
药物不良反应
有	766	32.61
无	1583	67.39