Abstract:Objective To analyze the basic characteristics of the therapy discontinued patients with multi-drug resistant pulmonary tuberculosis (MDR-TB) and to find the causes of therapy discontinuing. Methods Using case-control study method, a questionnaire survey was conducted to analyze the causes of MDR-TB in the treatment of interruption, and to compare the characteristics with the treatment completed patients, and to analyze the risk factors of discontinued therapy among MDR-TB patients. Results The study included 45 cases of therapy discontinued MDR-TB patients, and 45 cases of MDR-TB patients who had completed the treatment as the control. Multivariate logistic regression analysis results showed that patients with over 65 years old(OR=8.69, 95% CI=1.12,67.57), leak medication or drug withdrawal experience (OR=53.18,95% CI=5.90,479.27), were the risk factors of discontinued therapy(P<0.05). Patients with hospitalization for over 15 days was the protective factors for discontinued therpy(OR=0.09, 95% CI=0.01,0.58), (P<0.05). Conclusion advanced age≥65 years old, low income, leak medication or drug withdrawal experience short hospitalization periods were related to the risk of MDR-TB patients therapy discontinuing. were the key targets for patient management in the future.
[1]端木宏谨.加强对耐药结核病的研究[J].中华结核和呼吸杂志,2000,23(2):69-70. [2]王国杰,徐吉英,王国斌,等.河南省结核病耐药水平对全程督导短程化疗效果的影响[J].中华结核和呼吸杂志,2006,29(8):527-530. [3]明玉霞,卜希霞,许加芹.健康教育路径对耐多药肺结核患者遵医行为的影响[J].吉林医学,2013,33(8):1762-1763. [4]谭卫国,邓伟忠,赵梅桂,等.深圳市耐多药结核病人管治效果初步评价[J].中国防痨杂志, 2009, 31(5) : 256-258. [5]李丙喜.耐多药肺结核形成原因分析及防治对策[J].临床肺科杂志, 2010,15(10) :1497-1498. [6]曾丽翔,吴丽珊,王冬敏,等.抗结核药物副反应分析[J].临床肺科杂志, 2008, 13( 8) : 974-975. [7]张向荣,张侠,胡春梅,等.22例耐多药肺结核患者脱组原因分析与对策[J].临床肺科杂志, 2011, 16(12):1957-1958. [8]蔡云娥,姜慧敏,王东.肺结核患者服药依从性调查分析与护理对策[J].中华疾病控制杂志, 2011, 15(6):549-550. [9]施华芳,姜冬九,李乐之,等.病人依从性的研究进展[J].中华护理杂志,2003, 38(2): 134-136. [10]HILL PC, STEVENS W, HILL S, et al. Risk factors for defaulting from TB treatment:a prospective cohort study of 301 patients from The Gambia [J]. Int J Tub Lung Dis, 2005(12): 1349- 1354. [11]赵大海,徐飚.结核病与贫穷[J].中国防痨杂志,2004,2(3):177-179. [12]彭颖,陈松华,钟节鸣,等.耐多药肺结核患者未纳入诊治管理的原因分析[J].浙江预防医学,2014,26(3):272-274. [13]王海东,么鸿雁,黄飞,等.甘肃、河南和浙江三省肺结核患者/可疑患者的激励政策及效果评价[J].公共卫生与预防医学,2011,22(5):10-13. [14]JAKUBOWIAK W M,BOGORODSKAYA E M, BORISOV S E, et al. Social support and incentives programme for patients with tuberculosis: experience from the Russian Federation[J].Int J Tuberc Lung Dis,2007,11(11) :1210-1215. [15]MARTINS N, MORRIS P, KELLY P M. Food incentives to improve completion of tuberculosis treatment: randomised controlled trial in Dili, Timor-Leste[J].BMJ,2009,339(7730): 1131.