首次复治肺结核患者疗效影响因素分析

Analysis of factors influencing the efficacy of first-time cases of retreated pulmonary tuberculosis

目的了解影响首次复治肺结核患者疗效的因素。方法回顾性分析2002年1月—2004年12月上海市疾病预防和控制中心登记痰结核菌阳性(涂片阳性或培养阳性)的283例首次复治肺结核患者资料。对可能影响疗效的各种因素进行单因素和多因素分析。结果首次复治肺结核患者的总治愈率为74.9%。单因素分析有肺结核空洞、初治确诊延迟、初治用药数量、耐药性、不同复治类型和复治方案等6个因素与复治疗效有关。多因素分析显示:耐药性、不同复治类型和复治方案为影响首次复治肺结核患者疗效的主要因素。结论耐药、不同复治类型、复治方案是影响首次复治肺结核患者疗效的重要因素。

Objective To investigate the factors influencing the efficacy of first-time cases of retreated pulmonary tuberculosis （TB） patients. Methods The clinical data of 283 first-time retreated pulmonary TB patients with sputum positive （sputum smear/culture positive） in Shanghai CDC from January 2002 to December 2004 were retrospectively analyzed. Univariate X^2 test and multivariate logistic regression model were used for the analysis. Results The overall cure rate was 74.9% for the first-time cases of retreated pulmonary TB. Univariate analysis showed that the following 6 variables were correlated to the efficacy of retreatment： cavitary disease, diagnosis delay during initial treatment, number of drugs used in initial treatment, drug resistance, different retreated types and retreatment regimen. In multivariate analysis, it was confirmed that drug resistance, different retreated types and retreatment regimen were significantly associated with retreated outcomes. Conclusions Drug resistance, different retreated types and retreatment regimen are important factors influencing the efficacy of first-time retreated pulmonary TB.