摘要
目的:分析老年利福平耐药肺结核患者治疗转归及影响因素。方法:采用回顾性研究方法,参照入组标准收集2020年9月至2023年9月安徽省胸科医院收治的144例老年利福平耐药肺结核患者相关临床资料,分析患者治疗转归情况及影响因素。结果:144例老年利福平耐药肺结核患者中,治疗结局良好者65例(45.14%),包括治愈51例(35.42%)、完成疗程14例(9.72%);不良结局者79例(54.86%),包括失败7例(4.86%)、失访57例(39.58%)、死亡15例(10.42%),其中因结核病死亡7例。多因素logistic回归分析显示,体质量指数≥18.5(OR=0.131,95%CI:0.040~0.429,P<0.001)和长期督导管理(OR=0.052,95%CI:0.013~0.204,P<0.001)均是良好结局的保护因素,而合并糖尿病(OR=3.266,95%CI:1.074~9.936,P=0.037)和发生胃肠道反应(OR=8.976,95%CI:2.582~31.205,P<0.001)均是发生不良结局的危险因素。结论:安徽省老年利福平耐药肺结核患者治愈率较低,应重点关注合并糖尿病、营养状况欠佳、无长期督导服药管理及发生药物不良反应的老年患者,做到积极控制血糖水平、处理不良反应,加强营养支持和督导管理,进一步提高治愈率。
Objective:To analyze the treatment outcomes and influencing factors of elderly rifampicin drug-resistant pulmonary tuberculosis patients.Methods:A retrospective study was conducted,and clinical data of 144 elderly rifampicin drug-resistant pulmonary tuberculosis patients treated at the Anhui Chest Hospital from September 2020 to September 2023 were collected according to inclusion criteria.Treatment outcomes and influencing factors of patients were analyzed.Results:Among the 144 elderly drug-resistant pulmonary tuberculosis patients,65 cases(45.14%)had favorable treatment outcomes,including 51 cases(35.42%)cured and 14 cases(9.72%)completed treatment;79 cases(54.86%)had unfavorable treatment outcomes,including 7 cases(4.86%)getting treatment failure,57 cases(39.58%)lost to follow-up,and 15(10.42%)deaths,of which 7 were due to tuberculosis.Multifactor logistic regression analysis showed that body mass index(BMI)≥18.5(OR=0.131,95%CI:0.040-0.429,P<0.001)and long-term supervision and management(OR=0.052,95%CI:0.013-0.204,P<0.001)were protective factors for favorable outcomes,while comorbid diabetes(OR=3.266,95%CI:1.074-9.936,P=0.037)and gastrointestinal adverse reactions(OR=8.976,95%CI:2.582-31.205,P<0.001)were risk factors for unfavorable outcomes.Conclusion:The cure rate of elderly rifampicin drug-resistant pulmonary tuberculosis in Anhui Province was low.Attention should be paid to elderly patients with comorbid diabetes,poor nutritional status,lack of long-term supervised medicine taking and management,and drug adverse reactions.Active control of blood sugar levels,management of adverse reactions,strengthening nutritional support and supervision management are necessary to further improve the cure rate.
作者
高磊
梁雅雪
刘盛盛
王华
Gao Lei;Liang Yaxue;Liu Shengsheng;Wang Hua(Department of Drug-resistant Tuberculosis,Anhui Chest Hospital,Hefei 230022,China;Clinical College of Chest,Anhui Medical University,Hefei 230022,China;Department of Tuberculosis,Anhui Chest Hospital,Hefei 230022,China)
出处
《中国防痨杂志》
CAS
CSCD
北大核心
2024年第7期799-807,共9页
Chinese Journal of Antituberculosis
基金
2022年度安徽省卫生健康科研项目(AHWJ2022b040)。
关键词
老年
结核
肺
抗药性
细菌
治疗结果
因素分析
统计学
Elderly
Tuberculosis,pulmonary
Drug resistance,bacterium
Treatment outcome
Factor analysis,statistical
