中国耐多药肺结核不良治疗转归影响因素的Meta分析

评价耐多药肺结核(multidrug-resistant pulmonary tuberculosis，MDR-PTB)治疗转归的影响因素。方法： 通过计算机检索中文数据库(中国知网、万方数据库、中文科技期刊数据库、中国生物医学文献数据库)和英文数据库(PubMed、Embase、Web of Science)，搜集有...

Influencing factors of getting unfavorable treatment outcomes of patients with multidrug-resistant pulmonary tuberculosis in China: a Meta-analysis

Objective: To systematically review the influencing factors of unfavorable treatment outcomes of multidrug-resistant pulmonary tuberculosis (MDR-PTB) in China. Methods: Chinese databases (CNKI, WanFang Data, VIP, CBM) and English databases (PubMed, Embase, Web of Science) were electronically searched to collect studies about factors of unfavorable treatment outcomes of MDR-PTB. The time was limited as from inception of those databases to December 2021. Two researchers independently screened literatures, extracted information and evaluated the risk of bias. RevMan 5.3 was used to conduct Meta-analysis. Results: A total of 21 studies involving 4663 patients were included. Meta-analysis results showed that re-treatment (OR=2.63, 95%CI:1.54-4.47), complications (OR=4.28, 95%CI:2.61-7.03), adverse reactions (OR=2.71, 95%CI:1.87-3.93), cavity (OR=2.79, 95%CI:1.82-4.28), unreasonable chemotherapy (OR=5.80, 95%CI:2.05-16.41) and irregular treatment (OR=6.05, 95%CI:1.91-19.18) were associated with MDR-PTB treatment outcomes in multivariable analysis. Conclusion: The existing evidence suggested that re-treatment, complications, cavity, adverse reactions, unreasonable chemotherapy as well as irregular treatment were risk factors for unfavorable outcomes of MDR-PTB. In order to reduce the failure rate of MDR-PTB treatment, patients with these risk factors should receive strengthened medical managements and be cautious about the occurrence of adverse reactions.