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老年耐多药/利福平耐药肺结核患者的治疗转归及影响因素研究——全国多中心、回顾性队列研究

叶智腾 任斐 王华 杨铭 陈禹 陈晓红 王芸 范琳

中国防痨杂志2024，Vol.46Issue(9)：1023-1029,7.
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中国防痨杂志2024，Vol.46Issue(9)：1023-1029,7.DOI:10.19982/j.issn.1000-6621.20240215

老年耐多药/利福平耐药肺结核患者的治疗转归及影响因素研究——全国多中心、回顾性队列研究

Treatment outcomes and influencing factors in elderly patients with multidrug/rifampicin-resistant pulmonary tuberculosis:a national multicenter,retrospective cohort study

叶智腾 1任斐 2王华 3杨铭 4陈禹 5陈晓红 6王芸 7范琳1

作者信息

  • 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||同济大学附属上海市肺科医院,结核病临床研究中心,上海市结核(肺)重点实验室,上海 200433
  • 2. 西安市胸科医院耐药结核科,西安 710100
  • 3. 安徽省胸科医院耐药结核病科,合肥 230022
  • 4. 成都市公共卫生临床医疗中心结核科,成都 610061
  • 5. 沈阳市胸科医院儿童结核科,沈阳 110044
  • 6. 福建省福州肺科医院,福州 350008
  • 7. 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
  • 折叠

摘要

Abstract

Objective:To analyze treatment outcomes and influencing factors of multidrug/rifampicin-resistant pulmonary tuberculosis(MDR/RR-PTB)in elderly patients.Methods:A national multicenter retrospective cohort study was conducted to include 475 elderly(≥60 years)MDR/RR-PTB patients who were admitted to six provincial tuberculosis hospitals from January 1,2018 to December 31,2020.Clinical characteristics of those patients were recorded and full course treatment was followed up.Multivariable logistic regression model was used to analyze factors affecting treatment outcomes.Results:Successful treatment rate of 475 elderly MDR/RR-PTB patients was 65.89％(313/475),cure rate and treatment completion rate were 50.74％(241/475)and 15.16％(72/475)respectively.Treatment failure rate was 13.05％(62/475),loss of follow-up rate was 17.05％(81/475)and mortality rate was 4.00％(19/475).Multivariable logistic regression analysis showed that 70-79 years old(OR=1.560,95％CI:1.001-2.431),≥80 years old(OR=3.306,95％CI:1.370-7.974),lung cavities(OR=1.832,95％CI:1.195-2.808)were risk factors affecting MDR/RR-PTB treatment success in elderly patients.Inclusion of Bedaquiline in treatment regimen(OR=0.193,95％CI:0.044-0.841)was a protective factor for successful treatment.Conclusion:The treatment of elderly MDR/RR-PTB patients is complicated and difficult for which the successful treatment rate is low.Special attention should be paid to elderly patients aged ≥70 years and those with pulmonary cavities.

关键词

结核,抗多种药物性/治疗结果/老年人/多中心研究(主题)

Key words

Tuberculosis,multidrug-resistant/Treatment outcome/Aged/Multicenter studies as topic

分类

医药卫生

引用本文复制引用

叶智腾,任斐,王华,杨铭,陈禹,陈晓红,王芸,范琳..老年耐多药/利福平耐药肺结核患者的治疗转归及影响因素研究——全国多中心、回顾性队列研究[J].中国防痨杂志,2024,46(9):1023-1029,7.

基金项目

Medical Innovation Research Project of Shanghai Municipal Science and Technology Commission(21Y11901000) 上海市科委医学创新研究项目(21Y11901000) （21Y11901000）

中国防痨杂志

OA北大核心CSTPCD

1000-6621

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