我国耐多药结核患者治疗依从性影响因素meta分析

Factors influencing treatment compliance of patients with multidrug-resistant tuberculosis in China: a meta-analysis

目的系统评价耐多药结核患者治疗依从性的影响因素,为改善患者治疗依从性,提高治疗成功率提供依据。方法系统检索万方医学数据库、中国知网(China National Knowledge Infrastructure,CNKI)、中国生物医学文献数据库(Chinese Biological and Medical Database,CBM)中发表的耐多药结核患者治疗依从性影响因素的文献,采用Rev Man 5.3软件对纳入文献进行系统分析,包括异质性检验,计算各影响因素OR值及95%可信区间。结果共纳入文献14篇,meta分析结果显示,患者年龄、性别、文化程度、交通状况、病例来源、治疗经过对患者治疗依从性的影响没有统计学意义(P>0.05),患者疾病知晓率、经济状况及药物不良反应对依从性的影响有统计学意义(P<0.05),合并OR值和95%CI分别为3.26 (2.52~4.23)、2.80(1.61~4.86)和3.85(2.34~6.32)。结论影响患者治疗依从性的主要因素分别是患者的结核知晓率、经济条件、药物不良反应等因素。

Objective To systematically evaluate the factors influencing treatment compliance of patients with multidrug-resistant tuberculosis (MDR-TB) in China, and to provide a basis for improving their treatment compliance and increasing the successful rate of therapy.Methods Literatures relevant to the factors influencing treatment compliance of MDR-TB patients were searched online through Wanfang Database, China National Knowledge Infrastructure(CNKI), and Chinese Biological and Medical Database (CBM).RevMan 5.3 software was used to perform a meta-analysis, including conducting the heterogeneity test and caculating the OR value and 95% confidence interval (CI)of each influencing factor.Results A total of 14 literatures were collected. The results of meta-analysis showed that there was no statistically significant difference in treatment compliance affected by patients’ age, sex, education background, traffic status, sources of cases and treatment process (P>0.05), but statistically significant difference was found in treatment compliance affected by patients’ disease awareness rate (OR=3.26, 95%CI:2.52-4.23), economic situation (OR=2.80, 95%CI:1.61-4.86) and adverse drug reactions (OR=3.85, 95%CI:2.34-6.32),(all P<0.05).Conclusions The main factors influencing the patients’ treatment compliance are awareness rate of tuberculosis, economic status and adverse drug reactions.