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药物敏感型肺结核延长治疗疗程的患病率、临床原因及相关因素——一项真实世界研究

Prevalence, clinical reasons and associated factors of extended treatment duration for drug susceptible tuberculosis - a real-world experience.

作者信息

Liu Chih-Yu, Chen Rou-Tsern, Shu Chin-Chung, Lin Shu-Yung

机构信息

Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.

College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Sci Rep. 2025 Apr 27;15(1):14709. doi: 10.1038/s41598-025-97517-y.

Abstract

Limited research has been conducted on the prevalence and factors associated with extended drug-susceptible tuberculosis (TB) treatment. A retrospective study enrolled drug-susceptible TB patients (January 2018 to December 2020) from a hospital's registry to analyze prevalence, reasons, and factors for extended treatment (≥ 9 months) compared with standard course. Analyzing 221 TB patients, 80 patients received extended treatment. The extended group showed higher hepatitis B infection rates (12.5% vs. 5%, p = 0.043), recent cancer treatment (18.8% vs. 8.5%, p = 0.025), more adverse drug events (ADEs) (grade 3 or more severe ADEs 27.5% vs. 11.3%, p = 0.003), and treatment interruptions (46.3% vs. 18.4%, p < 0.001). Logistic regression highlighted hepatitis B infection (AOR 3.10, p = 0.039), recent cancer treatment (AOR 3.09, p = 0.013), and post-treatment elevated aminotransferase (AOR 2.40, p = 0.014) as independent factors for extended treatment. Extended anti-TB treatment affects 28.7% of patients, with host characteristics and adverse drug effects playing a role in treatment duration. Integrating these factors into treatment strategies is vital for optimal patient care.

摘要

关于广泛耐药结核病(TB)治疗的患病率及相关因素的研究有限。一项回顾性研究纳入了一家医院登记处2018年1月至2020年12月期间的药敏结核病患者,以分析与标准疗程相比延长治疗(≥9个月)的患病率、原因和因素。分析221例结核病患者,其中80例接受了延长治疗。延长治疗组的乙肝感染率更高(12.5%对5%,p = 0.043)、近期接受过癌症治疗(18.8%对8.5%,p = 0.025)、药物不良事件(ADEs)更多(3级或更严重的ADEs为27.5%对11.3%,p = 0.003)以及治疗中断情况更多(46.3%对18.4%,p < 0.001)。逻辑回归强调乙肝感染(比值比3.10,p = 0.039)、近期癌症治疗(比值比3.09,p = 0.013)以及治疗后转氨酶升高(比值比2.40,p = 0.01)是延长治疗的独立因素。延长抗结核治疗影响28.7%的患者,宿主特征和药物不良反应在治疗持续时间中起作用。将这些因素纳入治疗策略对优化患者护理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cb5/12034781/74a52e629463/41598_2025_97517_Fig1_HTML.jpg

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