利福平耐药结核病患者不良治疗结局及其影响因素研究进展

doi:10.19983/j.issn.2096-8493.2024111

摘要/Abstract

摘要：

近年来,耐药结核病的流行和传播给全球结核病控制带来了巨大的挑战,尤其是利福平耐药结核病,因其治疗周期长、治疗难度大、治疗费高、不良反应多等原因易出现中断治疗、治疗失败、失访等不良结局,严重影响患者治疗效果和生存质量。作者系统介绍了国内外利福平耐药结核病患者不良治疗结局的发生情况,探讨利福平耐药结核病不良治疗结局的影响因素,为制定提高利福平耐药结核病患者治疗效果的防治策略提供参考依据。

关键词: 结核, 利福平, 抗多种药物性, 治疗结果, 危险因素,统计学

Abstract:

In recent years, the prevalence and transmission of drug-resistant tuberculosis has posed significant challenges to global tuberculosis control, particularly rifampicin-resistant tuberculosis. This form of the disease is characterized by long treatment duration, difficulty in management, high costs, and numerous adverse reactions, which often lead to unfavorable treatment outcomes such as treatment interruption, treatment failure, and loss to follow-up, severely affecting treatment outcomes and quality of life. The authors systematically present the occurrence of adverse treatment outcomes among patients with rifampicin-resistant tuberculosis patients both domestically and internationally, and discusses the factors that influence these unfavorable outcomes, thereby providing a reference for the development of preventive and therapeutic strategies aimed at improving the treatment effectiveness of rifampicin-resistant tuberculosis patients.

Key words: Tuberculosis, Rifampin, Multidrug-resistant, Treatment outcome, Risk factors,statistical

中图分类号:

R521

孙慧娟, 苏伟, 陈伟. 利福平耐药结核病患者不良治疗结局及其影响因素研究进展[J]. 结核与肺部疾病杂志, 2024, 5(6): 573-582. doi: 10.19983/j.issn.2096-8493.2024111

Sun Huijuan, Su Wei, Chen Wei. Research progress on unfavourable treatment outcomes and risk factors of rifampicin-resistant tuberculosis patients[J]. Journal of Tuberculosis and Lung Disease, 2024, 5(6): 573-582. doi: 10.19983/j.issn.2096-8493.2024111

图/表 2

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发表年份	研究年份	作者	地区	样本量 (例)	不良治疗结局发生率(%)	治疗失败率(%)	病亡率 (%)	失访率 (%)	未评估率(%)
2021	2016—2016	Plesca等^[32]	摩尔多瓦共和国	287	21	5	8	8	-
2022	2011—2021	Belachew等^[15]	埃塞俄比亚	389	22.88	3.1	9.25	6.94	3.6
2019	2009—2014	Leveri等^[31]	坦桑尼亚	232	24.3	-	-	-	-
2021	2009—2019	Tola等^[30]	埃塞俄比亚	3395	24.3	1.7	12.8	9.7	-
2023	2021—2021	Kyrbashov等^[34]	吉尔吉斯斯坦	399	25.0	5.0	8.0	12.0	-
2022	2017—2021	Kamara等^[29]	塞拉利昂	365	26.0	-	-	-	-
2023	2011—2017	Choi等^[35]	韩国	7226	26.6	1.9	9.7	10.1	4.9
2020	2009—2019	Van等^[28]	越南	3395	26.7	-	-	-	-
2018	2013—2015	Trebucq等^[27]	西非和中非的9个国家	1006	27.6	5.9	7.8	4.8	-
2019	2012—2013	Makhmudova等^[26]	塔吉克斯坦	601	32	7	15	10	-
2024	2014—2019	Rafique等^[33]	巴基斯坦	275	32.4	-	19.6	12.7	-
2019	2013—2017	Gualano等^[25]	苏丹	156	36.5	-	14.1	-	-
2024	2017—2021	Chanda^[23]	赞比亚	183	37.2	-	21.3	6.0	9.8
2020	2010—2015	Matambo等^[21]	津巴布韦	473	39	1	26	8	3
2018	2009—2016	Ahmad等^[22]	25个国家	12030	39	8	14	-	-
2020	2010—2015	Tobon等^[20]	哥伦比亚	128	40	20.39	11.76	7.84	-
2020	2009—2014	Sharma等^[19]	印度	2958	46.72	-	-	-	-
2021	2014—2017	Khachatryan等^[18]	亚美尼亚	451	49.7	13.3	9.5	8	-
2021	2015—2017	Soeroto等^[16]	印度尼西亚	492	50%	-	-	-	-
2023	2018—2020	Gopalaswamy等^[24]	印度南部	217	52.0	3.2	13.8	14.3	20.7
2022	2016—2018	Indarti等^[17]	印度尼西亚	444	58.6	-	-	-	-

发表年份	研究年份	作者	范围	样本量	不良治疗结局发生率(%)	治疗失败率(%)	病亡率 (%)	失访率 (%)	未评估率(%)
2024	2018—2021	Fan等^[36]	全国6家结核病专科医院	3112	25.71	9.67	1.51	14.52	-
2024	2018—2020	叶智腾等^[37]	全国6家省级结核病专科医院	2291	27.28	11.39	1.44	14.45	-
2023	2010—2015	Lecai等^[14]	深圳市	261	28.9	11.5	0.4	8.0	8.8
2023	2011—2020	于全骥等^[40]	江苏省	2691	32.14	-	-	-	-
2022	2017—2019	Ma等^[38]	西安市	446	32.96	5.16	3.59	24.22	-
2023	2017—2018	宁晨曦等^[39]	上海市	182	34.6	7.7	4.9	8.2	13.7
2018	2014—2017	张哲^[48]	吉林省吉林市	227	34.81	22.90	0.44	-	-
2022	2008—2019	林志浩等^[45]	广东省佛山市	193	38.34	10.36	4.66	15.03	8.29
2023	2015—2021	杨奎等^[13]	湖北省	3799	38.70	2.68	7.96	18.20	9.86
2018	2014—2016	王艳敏^[49]	吉林省白山市	85	40	28.24	5.88	5.88	-
2022	2013—2016	李同心等^[42]	重庆市	548	41.24	31.20	3.28	6.75	-
2021	2014—2019	邝浩斌等^[47]	广州市	2417	43.18	-	-	-	-
2018	2012—2013	包昌琳等^[41]	湖南省	267	43.4	8.6	3.7	29.2	1.90
2020	2016—2017	殷美静等^[44]	西安市	96	45.82	14.58	6.25	25.00	-
2020	2016—2018	周正华等^[46]	广东省清远市	102	47.06	27.45	14.71	2.94	1.96
2021	2013—2020	郭雪丽等^[43]	贵州省	1446	63.87	-	3.38	16.08	-