耐多药肺结核疗效影响因素的meta分析

目的:系统评价耐多药肺结核疗效的影响因素,为耐多药肺结核的防治提供参考依据。方法:通过计算机检索、收集中文数据库(中国知网、维普、万方、Sinomed)和英文数据库(Pubmed、Web of science、Medline、Embase、Scopus)中耐多药肺结核疗效影响因素的病例对照研究,检索时限为建库至2023年1月,经筛选和质量评价后使用RevMan 5.4进行Meta分析。结果:最终纳入文献20篇,样本量为7328例。结果显示复治、并发症、不良反应、性别与耐多药肺结核的疗效相关,各因素OR值及其95%CI分别为0.22(0.17~0.29)、0.38(0.32~0.46)、0.27(0.17~0.44)、0.43(0.33~0.56)。结论:并发症、复治、不良反应、男性是耐多药肺结核治疗有效的危险因素,在临床实践中对于不同类型的患者需要更有针对性的措施。受研究数量的限制,上述结论需要更多研究予以论证。

Meta‑analysis of influencing factors associating with treatment outcome of multidrug resistant tuberculosis

Objective:To systematically review the influencing factors of the treatment outcome of multidrug-resistant pulmonary tuberculosis and provide reference for the prevention and treatment of multidrug-resistant pulmonary tuberculosis.Method:Case control studies on the factors influencing the treatment outcome of multidrug-resistant pulmonary tuberculosis in Chinese databases(CNKI,VIP,Wanfang,Sinomed)and English databases(Pubmed,Web of science,Medline,Embase,Scopus)were searched and collected by computer.The search period was from the establishment of the database to January 2023.After screening and quality evaluation,RevMan5.4 was used for meta-analysis.Result:Totally 18 articles were ultimately included,with a sample size of 7328 people.The results showed that retreatment,complications,adverse reactions,and gender were related to the treatment outcome of multidrug-resistant pulmonary tuberculosis.The OR values and 95%CI of each factor were 0.22(0.17-0.29),0.38(0.32-0.46),0.27(0.17-0.44),and 0.43(0.33-0.56),respectively.Conclusion:Complications,retreatment,adverse reactions,and male gender are effective risk factors for the treatment outcome of multidrug-resistant pulmonary tuberculosis.In clinical practice,more targeted measures are needed for different types of patients.Due to the limitations of the number of studies,the above conclusions require more research to support them.