涂阳肺结核患者抗结核药物不良反应发生影响因素分析

目的 探讨涂阳肺结核患者接受抗结核药物治疗的不良反应发生情况及其影响因素,为制定结核病防治策略提供参考。方法 选择2008—2010年我国8个省(市、自治区)结核病定点医疗机构治疗诊治的涂阳肺结核患者共2 142例,根据是否发生不良反应将其分为两组,运用卡方检验单因素及logistic多因素回归对不良反应发生的危险因素进行分析。结果 2 142例涂阳肺结核患者中536例患者出现不良反应,不良反应发生率为25.0%。经单因素分析结果表明年龄(χ²=23.815, P<0.001)、吸烟情况(χ²=12.040, P=0.024)及结果差异均有统计学意义。多因素非条件logistic回归结果显示, 45~64岁和≥65岁年龄组及吸烟是不良反应发生的独立危险因素,OR(95%CI)值分别为1.524(1.159~2.422)和1.756(1.200~2.570)及1.620(1.194~2.198)。结论 涂阳肺结核患者中吸烟及中老年人是发生不良反应的危险因素,在患者诊治过程中,应及时对这类高危人群进行监测和主动干预,对发现和降低不良反应的发生率有着重要意义。

Risk factors on adverse drug reactions of anti-tuberculosis treatment among smear-positive pulmonary tuberculosis patients

To analyze the incidence and risk factors of adverse drug reactions (ADRs) among smear-positive pulmonary tuberculosis (PTB) patients and provide reference for tuberculosis prevention and control strategy, 2 142 smear-positive pulmonary tuberculosis patients who were diagnosed and treated which from 8 provinces during 2008-2010 were involved in the study. We divided smear-positive PTB patients into ADR group and non-ADR group according to the appearance of adverse reactions. Chi-square test and multivariate logistic regression analysis were used to analyze related risk factors of ADRs.Results showed that 536 cases occurred ADRs among 2 142 smear-positive PTB patients, incidence rate was 25.0%. Univariate analysis showed that there were significant statistical difference between ADRs group and non-ADRs group in age (χ²=23.815, P<0.001) and smoking (χ²=12.040, P=0.024). Multivariate logistic regression analysis revealed ADRs was significantly related to 45-64 age group, 65 and above age group, current smoker, the OR (95% CI) were 1.524 (1.159-2.422), 1.756 (1.200-2.570) and 1.620 (1.194-2.198). In conclusion, the middle-aged and elderly, smoking were independent risk factors associated with ADRs. To monitor and intervene above risk population in the process of patients? diagnosis and treatment, it is important significance to find and reduce the incidence of adverse reactions.