丹东地区结核病患者复发率与治疗方案关系研究

Study on relations between recurrence rate of tuberculosis patients and chemotherapy regimen in Dandong

目的分析5种治疗方案对肺结核患者的治疗效果,对复发情况规律进行研究,为丹东地区最佳治疗疗程提供依据。方法对丹东市2008-2017年15330例确诊的结核病患者进行调查,对有差异的临床指标(P值均<0.05)进行Logistic回归统计分析和统计学检验,找出影响确诊的结核病复发率的因素。结果研究发现确诊的结核病患者复发率为4.11%。其中男性(复发率为4.70%)、>60岁(复发率为4.62%)、有空洞(复发率为6.94%)、合并糖尿病(复发率为6.43%)、痰涂片阳性(复发率为5.81%)等因素是肺结核患者治愈后复发的危险因素。Logistic回归分析显示,年龄>60岁[β=0.538,S_(X)=0.204,Waldχ^(2)=7.325,P=0.007,OR(95%CI)=1.753(1.620~2.658)]的患者和使用2H3R3Z3/4H3R3[β=0.488,S_(X)=0.190,Waldχ^(2)=1.325,P=0.291,OR(95%CI)=1.633(1.583~1.725)]治疗方案的患者是结核病患者复发的最主要因素。结论针对研究结果要进一步研究和采取有效的干预措施,以减少结核病复发。

Objective To analyze the therapeutic effects of 5 chemotherapy regimens on pulmonary tuberculosis patients,to study the recurrence law,and to provide the basis for optimum chemotherapy course in Dandong.Methods The investigation was conducted on 15330 confirmed tuberculosis patients in Dandong from 2008 to 2017,and logistic regression statistical analysis and statistical test were performed on differentiated clinical indicators(all P<0.05)to find out the tuberculosis patients whose confirmed factors for recurrence rate was influenced.Results It was found in the study that the recurrence rate of confirmed tuberculosis patients was 4.11%.Males(recurrence rate at 4.70%),over 60 years old(recurrence rate at 4.62%),cavities(recurrence rate at 6.94%),complicated with diabetes(recurrence rate at 6.43%),positive sputum smear(recurrence rate at 5.81%)and other factors are risk factors for recurrence of tuberculosis patients after cure.Logistic regression analysis showed that patients who were older than 60 years old[β=0.538,S_(X)=0.204,Waldχ^(2)=7.325,P=0.007,OR(95%CI)=1.753(1.620-2.658)]and patients who used 2 H3 R3 Z3/4 H3 R therapeutic regimen[β=0.488,S_(X)=0.190,Waldχ^(2)=1.325,P=0.291,OR(95%CI)=1.633(1.583-1.725)]are the most important factors causing recurrence of tuberculosis patients.Conclusion Further research and effective intervention measures should be taken based on research results to reduce tuberculosis recurrence.