包头市涂阳肺结核患者化疗效果及其影响因素分析

Analysis of the effect of supervision chemotherapy as well as affecting factors of smear positive tuberculosis patients in Baotou

目的评价包头市涂阳肺结核化疗效果,分析影响包头市涂阳肺结核化疗效果的因素。方法选择2005年1月至2009年12月包头市疾病预防控制中心痰涂片阳性的肺结核患者1993例,对性别、年龄、职业、户籍、就诊方式、诊断分型、重症肺结核、治疗分组、治疗方案、有无空洞、粟粒型肺结核、管理方式、转归等13个变量进行逐步回归分析,P〈0.05为差异有统计学意义。结果单因素分析显示年龄、职业、户籍、管理方式,其OR值（95%CI值）分别为0.981（0.972~0.990）、0.385（0.190~0.777）、0.235（0.144~0.384）、0.019（0.008~0.047）,P值分别为0.000、0.008、0.000、0.000,故年龄、职业、户籍、管理方式为涂阳肺结核化疗效果的影响因素。多因素分析显示年龄、职业、户籍、管理方式、治疗方案、粟粒型肺结核为化疗效果的影响因素,其中年龄（OR值0.989、P值0.037）、职业（OR值2.250、P值0.014）、粟粒型肺结核（OR值0.332、P值0.004）为危险性因素;户籍（OR值0.276、P值0.003）、管理方式（OR值0.010、P值0.000）、治疗方案（OR值10.719、P值0.036）为保护性因素。结论在化疗中对中老年男性、民工、患粟粒型肺结核的患者要高度重视,采取全程督导系统管理模式及高效的化疗方案,提高治愈率,减少复发。

Objective To evaluate the effect of supervision chemotherapy of smear positive tuberculosis patients in Baotou and analyze factors affecting the chemotherapy effect. Methods 1993 cases of tuberculosis patients with positive sputum smear examined in the Disease Prevention and Control Center of Baotou from January 2005 till December 2009 were selected and subjected to regression analysis in the following 13 categories including sex,age,vocation,household registration,hospital visit style,diagnosis classification,severe tuberculosis,treatment grouping,treatment plan,with or without cavity,with or without miliary tuberculosis,administrating manner,prognosis.P0.05 is considered statistically significant. Results Through single factor analysis,it has been found that the Odd Ratio（OR） and 95% Confidence Intervals（95% CI） for age factor are 0.981 and 0.972～0.990 respectively（with P value equal to 0.000）,the OR and 95% CI for vocation factor are 0.385 and 0.190～0.777 respectively（with P value equal to 0.008）,the OR and 95% CI for household registration factor are 0.235 and 0.0.144～0.384 respectively（with P value equal to 0.000）,the OR and 95% CI for administrating manner factor are 0.019 and 0.008～0.047 respectively（with P value equal to 0.000）,indicating that these four factors of age,vocation,household registration and administrating manner are factors affecting the effect of supervision chemotherapy of smear positive tuberculosis patients.Through multiple factor analysis,our data indicate that age,vocation,household registration,administrating manner,treatment plan,and miliary tuberculosis are factors affecting the effect of supervision chemotherapy.Among these factors,age（with OR of 0.989 and P of 0.037）,vocation（with OR of 2.250 and P of 0.014） and miliary tuberculosis（with OR of 0.332 and P of 0.004） are risk factors while household registration（with OR of 0.276 and P of 0.003）,administrating manner（with OR of 0.010 and P of 0.000）,and treatment plan（with OR of 10.719 and P of 0.036） are protective factors. Conclusion Our analysis indicates that extra attention ought to be paid to the following pulmonary tuberculosis patients including medium-elderly men,migrant workers,and miliary tuberculosis patients.Administrating mode of whole course supervision system and highly effective chemotherapy plan ought to be adopted to raise cure rate and lessen recurrence rate.