耐多药肺结核患者生命质量及其影响因素分析

目的 了解耐多药肺结核(MDR-TB)患者的生命质量,并分析其影响因素。方法 收集云南省2012—2015年在《结核病管理信息系统》中登记治疗管理的46例MDR-TB患者(MDR-TB组),采用1∶1配比病例对照研究,选取在这期间该系统登记治疗管理的对抗结核药物治疗敏感的肺结核患者46例作为对照组。采用横断面调查的方法,用《慢性病患者生命质量测定量表》中的《肺结核患者生命质量测定量表》(Quality of Life Instruments for Chronic Disease-Pulmonary Tuberculosis)测量并比较两组患者的生命质量,用多重线性回归分析法分析影响MDR-TB患者生命质量的因素。结果 MDR-TB组患者生命质量总得分、生理功能得分、心理功能得分、社会功能得分分别为(152.11±17.04)分、(35.85±5.53)分、(39.65±6.84)分、(29.52±4.92)分,低于对照组患者的(169.28±24.05)分、(41.39±5.53)分、(44.59±6.24)分、(32.91±5.66)分,差异均有统计学意义(t值分别为3.95、4.81、3.62、3.07,P值均<0.05);多重线性回归分析显示,MDR-TB患者生命质量的影响因素为治疗持续时间(β=15.17,t=2.28,P=0.028);46例MDR-TB患者治疗前生命质量得分为(139.33±12.86)分,治疗中得分为(151.75±16.56)分,治疗后得分为(169.67±17.67)分,MDR-TB患者生命质量随着治疗时间的延长而提高。结论 MDR-TB患者生命质量低于对抗结核药物治疗敏感的肺结核患者,治疗持续时间是MDR-TB患者生命质量可能的影响因素。

Analysis of the quality of life and its influencing factors in patients with multidrug-resistant tuberculosis

Objective To understand the life quality of patients with multidrug-resistant tuberculosis and analyze its influencing factors.Methods A total of 46 patients with multidrug-resistant pulmonary tuberculosis who were registered for the Tuberculosis Management Information System in Yunnan Province from 2012 to 2015 were collected (referred to as “MDR-TB group”). A 1∶1matched case-control study was performed in 46 patients with tuberculosis who were sensitive to the treatment during the period. A cross-sectional study was carried with Quality of Life Instruments for Chronic Disease-Pulmonary Tuberculosis in two groups. And the quality of life of the two groups was measured and compared, and multiple linear regression analysis was used to analyze the factors affecting the quality of life of patients with MDR-TB.Results The total quality of life score, physiological function score, psychological function score, social function score were (152.11±17.04), (35.85±5.53), (39.65±6.84), (29.52±4.92) points in MDR-TB group respectively compared with (169.28±24.05), (41.39±5.53), (44.59±6.24), (32.91±5.66) scores in control group, (t values were 3.95, 4.81, 3.62, and 3.07, respectively, and the P values were <0.05), scores in control group were lower, the difference was statistically significant. Multiple linear regression analysis showed that the influencing factor of quality of life in patients with MDR-TB was correlated with the duration of treatment (β=15.17, t=2.28, P=0.028). Forty-six patients with MDR-TB had a life quality score of (139.33±12.86) for pre-treatment, a score of (151.75±16.56) for treatment, and a score of (169.67±17.67) after treatment. The quality of life of MDR-TB patients increases with the treatment time.Conclusion The quality of life of MDR-TB patients is lower than that of tuberculosis patients who are sensitive to anti-tuberculosis drugs. The duration of treatment is a possible influencing factor in the quality of life of MDR-TB patients.