关键词: 结核, 肺, 结核, 抗多种药物性, 危险因素, 治疗结果, ROC曲线

Abstract:

Objective: To screen and evaluate the factors affecting treatment outcomes in patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB). Methods: Treatment outcome data of 308 patients with MDR-PTB in Xiamen from 2010 to 2019 were collected through the “Tuberculosis Information Management System”, a subsystem of the “China Disease Prevention and Control Information System”, then risk factors affecting the treatment outcome were analyzed, and the prediction model was built. Results: Of 226 (73.38%) out of these 308 patients were successfully treated. There were 82 cases (26.62%) getting adverse outcomes, including 52 cases (16.88%) with treatment failure, 17 cases (5.52%) died, and 13 cases (4.22%) getting adverse outcome with other causes. Factors influencing the treatment outcome were: male (OR=2.877, 95%CI: 1.356-6.104), age ≥50 years old (OR=1.833, 95%CI: 1.011-3.323), housewife/without a job (OR=0.352, 95%CI: 0.196-0.631), retreatment (OR=6.357, 95%CI: 1.842-21.944), sputum culture negative at 3 month (OR=0.162, 95%CI: 0.063-0.416). The area under ROC curve of the predictive model was 0.909 (95%CI: 0.871-0.938) based on combined predictors to predict the outcome of MDR-TB patients. Conclusion: Male, age ≥50 years old, retreatment patients and sputum culture positive at month 3 were risk factors for adverse outcomes in MDR-PTB patients, housewife/without a job were protective factor for adverse outcomes in MDR-PTB patients. The combined predictor model had fairly strong ability to predict adverse outcomes in patients with MDR-PTB after treatment.

Key words: Tuberculosis, pulmonary, Tuberculosis, multidrug-resistant, Risk factors, Treatment outcome, ROC curve