Pang Yu, Liu Rongmei, Song Yanhua, Lv Zizheng, Gao Mengqiu, Nie Lihui, Ge Qiping, Wu Xiaoguang
Department of Science and Technology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, People's Republic of China.
Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, People's Republic of China.
Infect Drug Resist. 2022 Jul 13;15:3725-3732. doi: 10.2147/IDR.S369715. eCollection 2022.
Cycloserine (CS) is a group B anti-tuberculosis (TB) drug endorsed by the World Health Organization (WHO) for the treatment of drug-resistant (DR)-TB. Despite CS widespread acceptance and known efficacy, the high potential of drug-associated psychiatric disorders is a major concern to multidrug-resistant (MDR)-TB patients. In this study, we investigated CS-associated psychiatric disorders in a cohort of MDR-TB patients in Beijing, China. Our aim was to determine psychiatric disorder prevalence rates and associated risk factors in this population.
This MDR-TB cohort study was conducted at Beijing Chest Hospital between February 2018 and February 2021. All patients received individualized treatment regimens that included CS at some point during the full treatment course. Patient psychological status was assessed using the Symptom Checklist (SCL-90) questionnaire during the post-treatment follow-up period.
Two hundred and thirty-seven MDR-TB patients were included in the final analysis. Overall, psychiatric disorders were recorded in 22 (9.28%) of the 237 patients in our cohort, with severity grades of 1 or 2 observed for the majority (8.44%) of psychiatric adverse events. As compared to results obtained for control group patients who were ≥40 years of age, patients who were <40 years of age (77.3%, 17/22) were more likely to experience psychiatric disorders [adjusted odds ratio (aOR) = 3.060; 95% CI (1.060-8.828)]. Additionally, patients with body mass index (BMI)s of <18.5 kg/m [aOR = 3.824; 95% CI (1.502-9.739)] had significantly higher odds of being afflicted with psychiatric disorders as compared with patients with BMIs that were ≥18.5 kg/m.
Our results demonstrated that approximately one-tenth of Chinese MDR-TB patients experienced psychiatric disorders during CS treatment, with the majority of adverse events of moderate severity. In addition, low BMI and age <40 years were identified as independent risk factors for psychiatric disorders in MDR-TB patients receiving CS therapy.
环丝氨酸（CS）是世界卫生组织（WHO）认可的用于治疗耐多药（MDR）结核病的B组抗结核药物。尽管CS被广泛接受且疗效确切，但药物相关精神障碍的高风险仍是耐多药结核病患者的主要担忧。在本研究中，我们调查了中国北京一组耐多药结核病患者中与CS相关的精神障碍。我们的目的是确定该人群中精神障碍的患病率及相关危险因素。
本耐多药结核病队列研究于2018年2月至2021年2月在北京胸科医院进行。所有患者在整个治疗过程中的某个阶段都接受了包含CS的个体化治疗方案。在治疗后随访期间，使用症状自评量表（SCL - 90）问卷对患者的心理状态进行评估。
最终分析纳入了237例耐多药结核病患者。总体而言，我们队列中的237例患者中有22例（9.28%）记录了精神障碍，大多数精神不良事件（8.44%）的严重程度为1级或2级。与年龄≥40岁的对照组患者的结果相比，年龄<40岁的患者（77.3%，17/22）更易出现精神障碍[调整后的优势比（aOR）= 3.060；95%置信区间（1.060 - 8.828）]。此外，体重指数（BMI）<18.5 kg/m²的患者[aOR = 3.824；95%置信区间（1.502 - 9.739）]与BMI≥18.5 kg/m²的患者相比，患精神障碍的几率显著更高。
我们的结果表明，约十分之一的中国耐多药结核病患者在CS治疗期间出现精神障碍，大多数不良事件为中度严重程度。此外，低BMI和年龄<40岁被确定为接受CS治疗的耐多药结核病患者发生精神障碍的独立危险因素。
