Zhao G, Cheng Q L, Xie L, Fang Z J, Song X
Division of Tuberculosis Prevention and Therapy, Hangzhou Center for Disease Control and Prevention, Hangzhou 310021, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2023 Mar 6;57(3):348-355. doi: 10.3760/cma.j.cn112150-20221011-00983.
To explore the influencing factors of the adverse outcome of pulmonary tuberculosis (PTB) among adolescents in Hangzhou City between 2005 and 2020. A retrospective cohort study was used to collect the information of adolescent PTB patients with the onset of PTB occurring from January 1, 2005 to December 31 in 12 designated tuberculosis hospitals in Hangzhou, mainly including demographic, epidemiological, clinical manifestations, bacteriological characteristics and other data, through the China Management Information System for Infectious Disease Surveillance and Reporting and the follow-up survey. All patients were followed up and the end time was December 31, 2021. Multivariate Cox regression model was used to analyze the factors affecting the adverse outcome of these patients. The mean age of 4 921 adolescent PTB patients was (18.9±3.6) years old, and the number of male and female patients were 3 074 and 1 847 respectively. The adverse outcome accounted for 14.7% (725) of all patients. Multivariate Cox regression model showed that eight risk factors, including management model from patients themselves or family members (=5.87, 95%: 4.55-7.64), molecular biology examination positive for PTB (=4.62, 95%: 2.98-7.19), the number of sputum smears-positive≥1 (=3.72, 95%: 2.87-4.83), non-standardized therapy regimens of PTB (=3.69, 95%: 2.95-4.64), history of retreated PTB (=2.22, 95%: 1.46-3.36), migrant adolescents (=1.89, 95%: 1.54-2.34), the number of chest X-ray scan (=1.83, 95%: 1.65-2.04), and severe PTB (=1.38, 95%: 1.02-2.05), were associated with the adverse outcome of adolescent PTB patients. Age (=0.94, 95%: 0.92-0.96), as the only protective factor, was associated with the adverse outcome of these patients. The management mode, molecular biological examination, chemotherapy program, history of tuberculosis, sputum smear examination, severity of tuberculosis, household residence, chest X-ray examination and age are associated with the adverse outcomes of adolescent PTB patients in Hangzhou.
为探讨2005年至2020年杭州市青少年肺结核(PTB)不良结局的影响因素。采用回顾性队列研究,通过中国传染病监测与报告管理信息系统及随访调查,收集2005年1月1日至2020年12月31日在杭州市12家指定结核病医院发病的青少年PTB患者信息,主要包括人口学、流行病学、临床表现、细菌学特征等数据。对所有患者进行随访,截止时间为2021年12月31日。采用多因素Cox回归模型分析影响这些患者不良结局的因素。4921例青少年PTB患者的平均年龄为(18.9±3.6)岁,男性患者3074例,女性患者1847例。不良结局占所有患者的14.7%(725例)。多因素Cox回归模型显示,患者本人或家庭成员管理模式(=5.87,95%:4.55 - 7.64)、PTB分子生物学检查阳性(=4.62,95%:2.98 - 7.19)、痰涂片阳性数≥1(=3.72,95%:2.87 - 4.83)、PTB治疗方案不规范(=3.69,95%:2.95 - 4.64)、复治PTB病史(=2.22,95%:1.46 - 3.36)、流动青少年(=1.89,95%:1.54 - 2.34)、胸部X线扫描次数(=1.83,95%:1.65 - 2.04)、重症PTB(=1.38,95%:1.02 - 2.05)这8个危险因素与青少年PTB患者的不良结局相关。年龄(=0.94,95%:0.92 - 0.96)作为唯一的保护因素,与这些患者的不良结局相关。管理模式、分子生物学检查、化疗方案、结核病史、痰涂片检查、结核病严重程度、户籍、胸部X线检查和年龄与杭州市青少年PTB患者的不良结局相关。