初治涂阳肺结核患者抗结核治疗不良反应发生现状及影响因素分析

目的探讨初治涂阳肺结核患者抗结核治疗不良反应发生现状，并分析其影响因素。 方法回顾性分析确诊并完成规范化治疗的初治涂阳肺结核患者280例的临床资料，总结抗结核治疗不良反应发生率、发生时间及类型，多因素Logistic回归分析其影响因素。 结果280例患者共发生抗结核治疗不良反应67例，不良反应发生率为23.93%；以单一症状不良反应为主，60例（89.55%）；大部分发生于强化期内，52例（77.61%）；以骨关节损害、肝功能损害、血液系统异常及胃肠道反应为主。不良反应组和非不良反应组年龄、体重指数、吸烟史、饮酒史、肝病史差异有统计学意义（P＜0.05或P＜0.01）。多因素Logistic回归分析显示：年龄＞60岁、体重指数＜18.5、吸烟史、饮酒史、肝病史是初治涂阳肺结核患者抗结核治疗不良反应发生的危险因素（P＜0.05或P＜0.01）。 结论初治涂阳肺结核患者规律抗结核治疗期间治疗相关不良反应以单一症状不良反应为主，大部分出现在强化期内，以骨关节损害、肝功能损害、血液系统异常及胃肠道反应为主；对年龄＞60岁、体重指数＜18.5、有吸烟史、有饮酒史、有肝病史的初治涂阳肺结核患者在行规律抗结核治疗期间要密切关注，减少或防止治疗相关不良反应的发生，提高治疗依从性并提高治愈率。

Analysis of the current status and influencing factors of adverse drug reactions in patients with newly-treated smear-positive pulmonary tuberculosis

ObjectiveTo investigate the current status of the adverse reactions of anti-tuberculosis treatment in patients with smear-positive pulmonary tuberculosis(SPPT) and to analyze the influencing factors. MethodsThe clinical data of 280 patients with newly-treated SPPT who were diagnosed and completed standardized treatment were analyzed retrospectively. The incidence, time and type of adverse reactions of anti-tuberculosis treatment were summarized. The influencing factors were analyzed by multivariate Logistic regression analysis. ResultsThere were 67 cases of adverse reactions in 280 patients receiving anti-tuberculosis treatment, with an incidence of 23.93%; the main adverse reactions were single symptom adverse reactions, involving 60 cases(89.55%), and most of them occurred in the intensive phase of tuberculosis treatment, involving 52 cases(77.61%). Most adverse reactions were bone joint damage, liver function damage, blood system abnormality and gastrointestinal reaction. Significant differences were found in the adverse reaction group and non-adverse reaction group with respect to the age, body mass index(BMI), smoking history, drinking history and liver disease history(P＜0.05 or P＜0.01). 〖JP2〗Multivariate Logistic regression analysis showed that age>〖JP〗60 years, BMI ＜18.5, smoking history, drinking history and liver disease history were the risk factors of the adverse reactions in patients with newly-treated SPPT during anti-tuberculosis treatment(P＜0.05 or P＜0.01). ConclusionThe main adverse reactions were single symptom adverse reactions in patients with newly-treated SPPT during the anti-tuberculosis treatment, and most of them occurred in intensive phase of tuberculosis treatment, mainly involving the bone joint damage, liver function damage, blood system abnormality and gastrointestinal reaction. Close attention should be paid to patients with newly-treated SPPT who were aged >60 years, and had BMI ＜18.5, smoking history, drinking history and liver disease history in the regular anti-tuberculosis treatment, and the occurrence of treatment-related adverse reactions should be reduced or prevented, thereby improving the treatment compliance and the cure rate.