2017-2021年云南省肺结核与糖尿病共病患者抗结核治疗效果及影响因素分析OA北大核心CSTPCD
Analysis of influencing factors of anti-tuberculosis treatment effect for pulmonary tuberculosis patients complicated with diabetes in Yunnan Province from 2017 to 2021
目的:分析云南省利福平敏感肺结核与糖尿病共病患者(简称"共病患者")抗结核治疗效果及影响治疗效果的危险因素,为改善共病患者抗结核治疗效果提供依据.方法:通过"中国疾病预防控制信息系统"子系统"监测报告管理系统"获取2017年1月1日至2021年12月31日云南省登记的共病患者病案信息,包括社会人口学信息、结核病诊断信息、抗结核治疗信息和抗结核治疗结局判定信息等,最终纳入3984例.分析共病患者抗结核治疗效果,并运用Cox回归模型分析影响共病患者治疗结局的危险因素.结果:3984例共病患者抗结核成功治疗率为89.36％(3560/3984),不良治疗结局发生率为10.64％(424/3984),死亡占4.27％(170/3984),治疗过程中丢失占2.46％(98/3984),失败占2.31％(92/3984),因药物不良反应中断治疗占1.61％(64/3984).44.22％(179/424)的不良结局发生在治疗的前2个月.Cox回归模型分析显示,≥65岁者出现不良治疗结局的风险较＜35岁者高(HR=2.612,95％CI:1.483～4.601),复治患者出现不良治疗结局的风险是初治患者的1.405倍(95％CI:1.072～1.843),病原学阳性者出现不良治疗结局的风险是阴性或未查患者的1.473倍(95％CI:1.183～1.834).结论:云南省共病患者抗结核治疗效果不佳,应重视共病患者,尤其是≥65岁老年人、复治、病原学阳性患者,抗结核治疗过程中治疗效果监测及健康管理,及时给予干预.
Objective:To analyze the treatment outcomes and risk factors among patients with rifampicin-sensitive tuberculosis-diabetes mellitus comorbidity(PTB-DM)patients in Yunnan Province,to provide evidence for improving the effect of anti-tuberculosis treatment for PTB-DM by.Methods:The medical data of PTB-DM patients registered in Yunnan Province from January 1,2017 to December 31,2021 were obtained through the"Monitoring Report Management System"of the"China Disease Prevention and Control Information System"subsystem,including sociodemographic information,tuberculosis diagnosis,anti-tuberculosis treatment and judgment of the treatment,3984 cases were finally included.The effectiveness of anti-tuberculosis treatment in PTB-DM patients was analyzed,and the risk factors of the treatment outcome were analyzed using Cox regression model.Results:The success rate of anti-tuberculosis treatment in 3984 PTB-DM patients was 89.36％(3560/3984),the incidence of adverse treatment outcomes of 10.64％(424/3984),the mortality was 4.27％(170/3984),and 2.46％(98/3984)were lost during treatment,with failure of 2.31％(92/3984)and discontinuation of treatment due to adverse drug reactions of 1.61％(64/3984).Of adverse outcomes,44.22％(179/424)occurred in the first 2 months of treatment.Cox regression model analysis showed that individuals aged≥65 had a higher risk of adverse treatment outcomes compared to those who aged＜35(HR=2.612,95％CI:1.483-4.601);the risk of adverse treatment outcomes in retreated patients was 1.405 times higher than that in newly treated patients(95％CI:1.072-1.843),and the risk of adverse treatment outcomes in pathogen positive patients was 1.473 times higher than that in other patients(95％CI:1.183-1.834).Conclusion:The effectiveness of anti-tuberculosis treatment for PTB-DM patients in Yunnan Province is not satisfactory,and attention should be paid to PTB-DM patients,especially elderly people aged 65 and above,re-treated,and pathogen-positive patients.During the anti-tuberculosis treatment,monitoring of treatment effectiveness and health management should be carried out,and timely intervention should be given.
杨蕊;李玲;陈金瓯;许琳
云南省疾病预防控制中心结核病防治所,昆明 650022
临床医学
结核,肺糖尿病共病现象治疗结果因素分析,统计学
Tuberculosis,pulmonaryDiabetes mellitusComorbidityTreatment outcomeFactor analysis,statistical
《中国防痨杂志》 2024 (005)
519-524 / 6
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