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中国西安耐多药结核病患者的治疗结果及危险因素:一项回顾性队列研究

Treatment Outcomes and Risk Factors of Multidrug-Resistant Tuberculosis Patients in Xi'an China, a Retrospective Cohort Study.

作者信息

Ma Jin-Bao, Zeng Ling-Cheng, Ren Fei, Dang Li-Yun, Luo Hui, Wu Yan-Qin, Yang Xin-Jun, Li Rong, Yang Han, Xu You

机构信息

Department of Drug-Resistance Tuberculosis, Xi'an Chest Hospital, Xi'an, People's Republic of China.

Xi'an Center for Disease Control and Prevention, Xi'an, People's Republic of China.

出版信息

Infect Drug Resist. 2022 Aug 29;15:4947-4957. doi: 10.2147/IDR.S376177. eCollection 2022.

Abstract

BACKGROUND

Long-term regimens are widely used for multidrug-resistant tuberculosis (MDR-TB) in North-West China; however, risk factors associated with the treatment outcomes are not well known.

METHODS

This was a retrospective cohort study of MDR-TB patients treated with longer regimen in Xi'an from 2017 to 2019. Risk factors associated with the treatment outcome were analyzed using multiple logistic regression.

RESULTS

Of the 446 patients with MDR-TB included, 215 were cured, 84 completed treatment, 23 failed treatment, 108 were lost to follow-up, and 16 died. Unfavorable outcome risk factors were age >40 years (OR = 3.25, 95% CI = 2.12-4.98), male sex (OR = 2.53, 95% CI = 1.52-4.22), and re-treated tuberculosis (OR = 1.70, 95% CI = 1.11-2.61), whereas poor treatment outcome risk factors were age >40 years (OR = 5.51, 95% CI = 2.52-12.07), fluoroquinolones not used in the regimen (OR = 3.31, 95% CI = 1.45-7.51), and smear-positive (OR = 4.0, 95% CI = 1.47-10.8).

CONCLUSION

In Xi'an, MDR-TB treatments with long-term regimens had low success rates, and age, sex, and tuberculosis treatment history were risk factors of MDR-TB treatment outcomes.

摘要

背景

在中国西北部,长期治疗方案被广泛用于耐多药结核病(MDR-TB)的治疗;然而,与治疗结果相关的风险因素尚不明确。

方法

这是一项对2017年至2019年在西安接受较长疗程治疗的耐多药结核病患者的回顾性队列研究。使用多因素逻辑回归分析与治疗结果相关的风险因素。

结果

纳入的446例耐多药结核病患者中,215例治愈,84例完成治疗,23例治疗失败,108例失访,16例死亡。不良结局的风险因素为年龄>40岁(OR = 3.25,95%CI = 2.12 - 4.98)、男性(OR = 2.53,95%CI = 1.52 - 4.22)和复治结核病(OR = 1.70,95%CI = 1.11 - 2.61),而治疗效果不佳的风险因素为年龄>40岁(OR = 5.51,95%CI = 2.52 - 12.07)、治疗方案中未使用氟喹诺酮类药物(OR = 3.31,95%CI = 1.45 - 7.51)和涂片阳性(OR = 4.0,95%CI = 1.47 - 10.8)。

结论

在西安,长期治疗方案的耐多药结核病治疗成功率较低,年龄、性别和结核病治疗史是耐多药结核病治疗结果的风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64ab/9438796/29133914be97/IDR-15-4947-g0001.jpg

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