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影响肺结核治疗成功结局的因素:2005 - 2011年土耳其单中心经验

Factors affecting successful treatment outcomes in pulmonary tuberculosis: a single-center experience in Turkey, 2005-2011.

作者信息

Sengul Aysun, Akturk Ulku Aka, Aydemir Yusuf, Kaya Nurullah, Kocak Nagihan Durmus, Tasolar Fatma Turan

机构信息

Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey.

出版信息

J Infect Dev Ctries. 2015 Aug 29;9(8):821-8. doi: 10.3855/jidc.5925.

DOI:10.3855/jidc.5925
PMID:26322873
Abstract

INTRODUCTION

We aimed to describe the treatment outcomes in patients with bacteriologically confirmed pulmonary tuberculosis (PTB) and identify factors associated with successful treatment outcome.

METHODOLOGY

The medical charts of patients with smear and/or culture-positive PTB who were treated between 2005 and 2011 at the Kocaeli Tuberculosis Dispensary, Turkey, were reviewed. Patients were categorized as having a successful (cured or with a completed treatment) or poor (treatment default, treatment failure, death) treatment outcome. The association of demographic and clinical factors, including gender, age, education, occupation, insurance, family size, living area, smear and culture positivity, retreatment, comorbidity, drug resistance, and cavity on radiography, with the success of treatment, was evaluated by univariate and multivariate analyses.

RESULTS

Of 738 patients (258 females, 480 males) with bacteriologically confirmed PTB, 683 (92.6%) had successful treatment outcomes. Of those with a poor outcome, 29 (3.9%) had treatment default, 18 (2.4%) died, and 8 (1.1%) had treatment failure. Young age, no previous treatment, no comorbidity, no drug resistance, and high education level were factors significantly associated with successful PTB treatment outcome (p < 0.05 for all).

CONCLUSIONS

Treatment outcome was successful in young and educated PTB patients who had drug resistance, previous treatment history, and no comorbidities. Knowledge of the factors affecting treatment success will lead to the undertaking of specific measures in the management of PTB, which may help to decrease treatment failure.

摘要

引言

我们旨在描述细菌学确诊的肺结核(PTB)患者的治疗结果,并确定与治疗成功相关的因素。

方法

回顾了2005年至2011年在土耳其科贾埃利结核病诊疗所接受治疗的涂片和/或培养阳性PTB患者的病历。患者被分类为治疗结果成功(治愈或完成治疗)或不佳(治疗中断、治疗失败、死亡)。通过单因素和多因素分析评估人口统计学和临床因素,包括性别、年龄、教育程度、职业、保险、家庭规模、居住地区、涂片和培养阳性、复治、合并症、耐药性以及影像学上的空洞,与治疗成功之间的关联。

结果

在738例细菌学确诊的PTB患者中(258例女性,480例男性),683例(92.6%)治疗结果成功。治疗结果不佳的患者中,29例(3.9%)治疗中断,18例(2.4%)死亡,8例(1.1%)治疗失败。年轻、无既往治疗史、无合并症、无耐药性以及高教育水平是与PTB治疗成功显著相关的因素(所有p<0.05)。

结论

年轻且受过教育、无耐药性、无既往治疗史且无合并症的PTB患者治疗结果成功。了解影响治疗成功的因素将有助于在PTB管理中采取具体措施,这可能有助于减少治疗失败。

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