关键词: 结核,肺, 治疗结果, 因素分析,统计学, 天津

Abstract:

Objective: To analyze the influencing factors of treatment failure in initially treated patients with bacterial positive pulmonary tuberculosis, and provide evidence for improving the treatment success rate. Methods: A retrospective study was conducted to collect the clinical data of 392 new patients with positive bacteria results, who were registered from January to December 2020 in Tianjin Tuberculosis Control Center and completed a one-year follow-up. The data was extracted from Hospital Information System of Tianjin Tuberculosis Control Center. The data included sex, age, marriage, occupation, education level, income, living conditions, smoking and alcohol history, body mass index, basic diseases, symptomatic visits, whether regular physical examination, delayed visits, delayed diagnosis, adverse drug reactions, whether regular drug use, drug resistance of Mycobacterium tuberculosis, and imaging examination results. Single- and multi-variable logistic regression models were used to analyze the factors associated with treatment failure. Results: Among 392 patients, the failure rate of pulmonary tuberculosis treatment was 8.16% (32/392). The multivariate logistic regression analysis showed that the presence of adverse drug reactions (OR=3.109, 95%CI: 1.186-8.151), delayed visits (OR=2.028, 95%CI: 1.742-5.541), delayed diagnosis (OR=3.231, 95%CI: 1.213-8.604), Mycobacterium tuberculosis resistance (OR=8.478, 95%CI: 2.111-34.055), and irregular medication use (OR=1.825, 95%CI: 1.185-2.810) were risk factors for treatment failure, while regular health examinations (OR=0.568, 95%CI: 0.357-0.904) was protective factor for treatment failure in new bacterial positive patients. Conclusion: Improving regular health examinations to detection of potential patients as early as possible, promoting of patients with suspected tuberculosis symptoms to seek medical service and receiving timely diagnosis, carrying out self-management awareness of drug resistance testing, active handling of adverse drug reactions during treatment, strengthening medication safety guidance, guiding patients to improve their own lifestyle habits and medication compliance can all improve the success rate of treatment for new bacterial positive pulmonary tuberculosis patients.

Key words: Tuberculosis, pulmonary, Treatment outcome, Factor analysis, statistical, Tianjin City