2021-2022年开封市城区涂阳肺结核患者治疗2月末痰菌阴转情况分析

Analysis of Sputum Negative Transformation at the End of 2 Months after Chemotherapy in Patients with Smear-positive Pulmonary Tuberculosis in Kaifeng City from 2021 to 2022

目的分析开封市城区2021-2022年涂阳肺结核患者治疗2月末痰菌阴转情况,并对其相关影响因素分析,以便为临床治疗策略制定提供参考。方法选取179例2021~2022年开封市城区登记上报的涂阳肺结核病例,均予以规范化抗结核化疗治疗,统计其治疗2月末痰菌阴转情况,并以患者治疗2月末痰菌阴转结果为因变量,分析影响痰菌阴转结果的相关因素。结果纳入的179例患者抗结核化疗治疗2月末,痰菌阴转157例,占比87.71%;痰菌未转阴22例,占比12.29%。经单因素、多因素回归分析显示,治疗前痰涂片结果、异烟肼/利福平耐药情况都是影响患者治疗2月末痰菌阴转情况的独立危险因素(P<0.05)。结论2021-2022年开封市城区部分涂阳肺结核患者治疗2月末仍存在痰菌未阴转的情况,临床应高度重视影响患者痰菌阴转的危险因素,有针对性地进行干预与监测,以便更好地控制传染源,提高患者痰菌阴转率。

Objective To analyze the sputum negative transformation at the end of 2 months after chemotherapy in patients with smear-positive pulmonary tuberculosis in the urban area of Kaifeng City from 2021 to 2022,and to analyze the related influencing factors.Methods 179 smear positive pulmonary tuberculosis cases registered and reported in the urban area of Kaifeng City from 2021 to 2022 were selected and treated with standardized antituberculosis chemotherapy.The sputum bacteria negative conversion at the end of two months of treatment was statistically analyzed.The sputum bacteria negative conversion results of patients at the end of two months of treatment were taken as the dependent variable to analyze the related factors affecting the sputum bacteria negative conversion results.Results At the end of 2 months of anti tuberculosis chemotherapy treatment for 179 patients included,157 cases(87.71%)had sputum negative conversion;22 cases(12.29%)of sputum bacteria did not turn negative.Single factor and multiple factor regression analysis showed that the sputum smear results before treatment and Isoniazid/Rifampicin resistance were independent risk factors affecting the sputum bacteria negative conversion at the end of 2 months of treatment(P<0.05).Conclusions Some smear positive pulmonary tuberculosis patients in Kaifeng City from 2021 to 2022 still have sputum negative conversion at the end of two months of treatment.Clinically,we should attach great importance to the risk factors that affect the negative conversion of sputum bacteria,and carry out targeted intervention and monitoring to better control the source of infection and improve the negative conversion rate of sputum bacteria in patients.