College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
Int J Infect Dis. 2012 Feb;16(2):e130-5. doi: 10.1016/j.ijid.2011.10.007. Epub 2011 Dec 18.
The aim of this study was to evaluate the reversible factors that could possibly affect outcomes of anti-tuberculosis (anti-TB) treatment.
A retrospective observational nested case-control study was performed to evaluate the association of patient and clinical factors with anti-TB therapy outcomes as defined by the World Health Organization (WHO).
To examine the impact of a variety of factors on the outcomes of anti-TB treatment, a total of 302 TB patients were included in the study. Univariate analysis revealed that age, gender, concurrent hypertension, asthma/chronic obstructive pulmonary disease, or liver disease, worsened baseline blood urea nitrogen or creatinine, ethambutol <800 mg/day, hepatitis or adverse skin reactions during therapy, smoking history, and current tobacco consumption were significant factors in decreasing both the cure rate and treatment completion rate. However, multivariate regression showed that only age, current daily tobacco consumption, baseline liver disease, and ethambutol dosage were independent factors. A high level of tobacco consumption (>20 cigarettes per day) was significantly associated with a decreased odds of cure or treatment completion (odds ratio 0.23, 95% confidence interval 0.05-0.98, p=0.047).
As smoking significantly inhibits the effectiveness of TB treatment, the integration of smoking cessation into TB treatment programs is strongly advocated to reduce the dual global burden of smoking and TB.
本研究旨在评估可能影响抗结核（anti-TB）治疗结果的可逆因素。
采用回顾性观察性巢式病例对照研究，评估患者和临床因素与世界卫生组织（WHO）定义的抗 TB 治疗结果的相关性。
为了研究各种因素对抗 TB 治疗结果的影响，共纳入 302 例 TB 患者进行研究。单因素分析显示，年龄、性别、合并高血压、哮喘/慢性阻塞性肺疾病或肝病、基线血尿素氮或肌酐恶化、乙胺丁醇<800mg/天、治疗期间肝炎或不良反应、吸烟史和当前吸烟量是降低治愈率和治疗完成率的显著因素。然而，多变量回归显示，只有年龄、当前每日吸烟量、基线肝病和乙胺丁醇剂量是独立因素。高水平的吸烟（>20 支/天）与降低治愈或治疗完成的几率显著相关（比值比 0.23，95%置信区间 0.05-0.98，p=0.047）。
由于吸烟显著抑制了结核病治疗的效果，因此强烈主张将戒烟纳入结核病治疗方案，以减轻吸烟和结核病的双重全球负担。
