灌云县结核病治疗依从性及社会经济和临床影响因素研究

Research of TB Treatment Compliance and Socio!economic and Clinical Factors Influencing it in Guanyun County

目的了解结核病人治疗的依从性以及影响治疗依从性的社会经济及临床影响因素。方法以2003年6月1日至2005年5月31日的330例初治和143例复治肺结核病人作为研究对象,进行治疗期2个月末、5个月末和治疗结束的随访问卷调查。结果初治和复治病人2个月治疗依从率分别为90.0%和84.6%,全程治疗依从率分别为90.0%和79.7%。BMI指数、出现副作用和药品费用影响常住病人抗结核治疗的依从性。随着BMI指数的升高,结核病人更倾向于依从抗结核治疗(OR=1.21,P=0.035);出现副作用的结核病人依从性差于无副作用病人(OR=0.14,P=0.020);在治疗过程中支付较低费用的病人依从性优于最高费用组(OR=44.52,P=0.038)。结论灌云县结核病的治疗具有较高的依从率,初治病人的治疗依从性高于复治病人,药物副作用和由此引发的医疗费用正成为该地区结核病治疗依从的障碍。

OBJECTIVE To research TB treatment compliance and socio-economic, clinical factors impact on it. METHODS Take the 330 newly-treated and 143 retreated tuberculosis patients of June 1, 2003 to May 31, 2005 patients as subject investigated, carrying on follow-up visit and questionnaire survey at the end of the second and the fifth month during the treatement period, also when the treatment finished. RESULTS Treatment compliance rates of newly-treated and re-treated patients are respectively 90.0% and 84.6%, fullperiod treatment rates are 90.0% and 79.9%. BMI index, suffering from side effects anddrug costs affect the anti-tuberculosis treatment compliance of patients who have to live longer in hospital.With the increase of BMI, TB patients tend tO follow anti-tuberculosis treatment （OR=1.21, P=0.035）, resulting in poor compliance rate of the TB patients without side-effects （OR=0.14, P=0.020） ; in the course of treatment, compliance is superior in the patients who had to offer lower expenses to those who had to offer more （OR=44.52, P=0.038） . CONCLUSIONS The treatment of TB in guanyun County has a high compliance rate that newly-treated patients are higher than re-treated ones. Drug side effects and medical expenses arising from the treatment of TB in the region is becoming an obstacle to compliance.