2004—2008年上海市浦东新区居民肺结核病死率相关危险因素分析

Risk Factor Analysis on Fatality Rate of Tuberculosis Patients in Pudong New Area in Shanghai( 2004- 2008)

目的探讨上海市浦东新区居民肺结核死亡相关危险因素。方法应用Kaplan-Meier法、Log-rank检验和Cox多元回归模型对2004年1月1日—2008年12月31日确诊的肺结核1570例的年龄、性别、发病类型、首次痰涂片结果、合并疾病、病变范围、耐药情况等对肺结核死亡的影响进行分析。结果单因素分析结果显示,年龄≥60岁、男性、首次痰涂片结果阳性、复治、诊断延误、病变≥3个肺野、耐多药、合并其他疾病是肺结核患者死亡的危险因素(P<0.05,P<0.01)。多因素Cox多元回归模型分析表明,年龄、性别、首次痰涂片结果、治疗分类、病变范围、合并其他疾病是肺结核患者死亡的相关危险因素(P<0.05)。结论对老年、男性、首次痰涂片结果阳性、复治、病变范围大、合并其他疾病的肺结核患者采取相应的防治措施,可能会降低肺结核患者的病死率。

Objective To investigate the risk factors of death of tuberculosis（ TB） patients in Pudong New Area in Shanghai. Methods A total of TB 1570 patients diagnosed from January 1,2004 to December 31,2008 were recruited in this study,and the effects of age,gender,pathogenesy types,results of first sputum smear,other combined diseases and drug resistance on the death induced by TB were analyzed using Kaplan-Meier method,Log-rank test and Cox multivariate regression model. Results The result of single factor analysis showed that male patients more than 60 years old with positive result of first sputum smear,retreatment,delaying diagnosis and treatment,lesions range equal to or more than 3 lung fields,multiple drug resistant pulmonary tuberculosis and other combined diseases were the risk factors of death of TB patients（ P 0. 05,P 0. 01）. The result of Cox multivariate regression analysis showed that age,gender,result of first sputum smear,treatment methods,lesions range and other combined diseases were the risk factors of death of TB patients（ P 0. 05）. Conclusion Related measures can be given to the male elderly TB patients with positive result of first sputum smear,retreatment,large lesions range and other combined diseases,which may reduce the mortality rate of TB patients.