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结核病患者队列中死亡率危险因素的生存分析。

Survival Analysis of Risk Factors for Mortality in a Cohort of Patients with Tuberculosis.

机构信息

Department of Prevention, Haihe Hospital, Tianjin University, Tianjin, China.

Tianjin Key Laboratory of Lung Regenerative Medicine, Tianjin, China.

出版信息

Can Respir J. 2020 Sep 5;2020:1654653. doi: 10.1155/2020/1654653. eCollection 2020.

Abstract

Identify the treatment effects and risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under the Directly Observed Treatment Short-Course (DOTS) program to reduce the mortality rate of tuberculosis. A retrospective cohort analysis was conducted on the outcomes of antituberculosis treatment of 7,032 patients with tuberculosis in the DOTS program, in the Tuberculosis Management Information System from 2014 to 2017 in Tianjin, China. The Kaplan-Meier method and multifactor Cox proportional risk regression model were used to analyze the risk factors for mortality during antituberculosis treatment under DOTS. The success rate of antituberculosis treatment was 90.24% and the mortality rate was 4.56% among 7,032 cases of tuberculosis in Tianjin. Cox regression analysis showed that advanced age, male sex, human immunodeficiency virus (HIV) positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) were risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under DOTS. The treatment effects in patients with pulmonary tuberculosis during antituberculosis treatment under DOTS were positive in Tianjin. Advanced age, male sex, HIV positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) increased the risk for mortality during antituberculosis treatment.

摘要

确定在直接观察短期疗程(DOTS)方案下接受抗结核治疗的肺结核患者的治疗效果和死亡风险因素,以降低结核病死亡率。对 2014 年至 2017 年期间中国天津市结核病管理信息系统中 DOTS 方案下 7032 例肺结核患者的抗结核治疗结局进行回顾性队列分析。采用 Kaplan-Meier 法和多因素 Cox 比例风险回归模型分析 DOTS 下抗结核治疗期间死亡的风险因素。结果显示,在天津市 7032 例肺结核患者中,抗结核治疗成功率为 90.24%,死亡率为 4.56%。Cox 回归分析显示,高龄、男性、人类免疫缺陷病毒(HIV)阳性、初治阳性、复治和就诊延迟(≥14 天)是 DOTS 下接受抗结核治疗的肺结核患者死亡的风险因素。在天津市,DOTS 下肺结核患者的抗结核治疗效果为阳性。高龄、男性、HIV 阳性、初治阳性、复治和就诊延迟(≥14 天)会增加抗结核治疗期间的死亡风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cadc/7492936/52d6d0bdccbe/CRJ2020-1654653.001.jpg

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