|
|
|
| Influencing factors for recurrence of pulmonary tuberculosis among patients with initial treatment success |
| ZHANG Ruodi, YANG Li, TENG Nan, CHEN Tengwei, XU Yuanyuan
|
| Taizhou Center for Disease Control and Prevention (Taizhou Institute of Public Health Supervision),Taizhou, Zhejiang 318000, China |
|
|
|
|
Abstract Objective To analyze the recurrence and influencing factors of pulmonary tuberculosis among patients with initial treatment success, so as to provide evidence for preventing pulmonary tuberculosis recurrence. Methods Patients with initial treatment success for pulmonary tuberculosis confirmed in Taizhou City, Zhejiang Province from 2010 to 2024 were selected as study subjects. Data including basic information, comorbidities and etiological results were collected through the Tuberculosis Management Information System of China Disease Prevention and Control Information System. A retrospective cohort study was conducted. The end date of initial treatment success was set as the starting point of observation, and 2025 was set as the end point of observation. Pulmonary tuberculosis recurrence (re-diagnosis of pulmonary tuberculosis ≥6 months after the completion of initial treatment success) was set as the outcome event. A multivariable Cox proportional hazards regression model was used to analyze the influencing factors for recurrence of pulmonary tuberculosis among patients with initial treatment success. Results A total of 37 236 patients with initial treatment success for pulmonary tuberculosis were enrolled, including 25 879 males (69.50%) and 11 357 females (30.50%). The mean age of patients was (46.09±19.34) years. The median follow-up duration was 7.85 (interquartile range, 7.75) years. A total of 873 recurrence cases were identified, with a recurrence rate of 2.34%. Multivariable Cox proportional hazards regression analysis showed that male patients had a 32.2% (HR=1.322, 95%CI: 1.129-1.548) higher recurrence risk than female patients. Each one-year increase in age was associated with a 1.6% (HR=1.016, 95%CI: 1.012-1.020) higher recurrence risk. Compared with farmers, workers and students had 27.5% (HR=0.725, 95%CI: 0.587-0.895) and 51.0% (HR=0.490, 95%CI: 0.265-0.908) lower recurrence risk, respectively. Patients with positive etiology had a 60.1% (HR=1.601, 95%CI: 1.396-1.835) higher recurrence risk than those with negative or missing etiology. Conclusion Gender, age, occupation and etiological results were possibly associated with recurrence of pulmonary tuberculosis among patients with initial treatment success.
|
|
Received: 27 May 2026
Revised: 25 August 2026
Published: 22 September 2026
|
|
|
|
|
|
[1] 李涛,赵雁林,贾忠伟.结核病复发及其影响因素研究进展[J].疾病监测,2024,39(4):403-411. [2] Li T,Zhang B,Du X,et al.Recurrent pulmonary tuberculosis in China,2005 to 2021[J/OL].JAMA Netw Open,2024,7(8)[2026-08-25].http://doi.org/10.1001/jamanetworkopen.2024.27266. [3] 常玥,章亚夫,许圆圆,等.浙江台州肺结核流行特征分析(2011—2021年)[J].国际流行病学传染病学杂志,2023,50(5):353-356. [4] 杨利,常玥,林海江.2016—2021年台州市肺结核流行特征分析[J].预防医学,2022,34(11):1150-1155. [5] Hu Y D,Wang M,Gao Y,et al.Epidemiological analysis and risk factors of recurrent pulmonary tuberculosis in western Zhejiang Province,China(2007-2024)[J/OL].Front Public Health,2026,14[2026-08-25].http://doi.org/10.3389/fpubh.2026.1777279. [6] WS 288—2017 肺结核诊断[S]. [7] WS 196—2017 结核病分类[S]. [8] 中国疾病预防控制中心结核病预防控制中心.中国结核病防治工作技术考核手册[M].北京:人民卫生出版社,2021. [9] 姜游力,张培泽,邓国防,等.结核病患者诊断延迟及其影响因素研究进展[J].结核与肺部疾病杂志,2021,2(3):289-293. [10] 王荣,许可,洪忻,等.南京市初治肺结核患者成功治疗后复发及影响因素分析[J].中国热带医学,2022,22(8):735-738,752. [11] 张红伟,陈曦,孙闪华,等.北京市初治肺结核患者治疗成功后复发情况及危险因素分析[J].疾病监测,2021,36(8):818-823. [12] 孙晴,王小平,符剑,等.2013—2020年江苏省南通市初治结核病患者成功治疗后复发情况及其影响因素分析[J].疾病监测,2024,39(10):1270-1275. [13] 严天心,马文斌,王嘉,等.2010—2023年中国肺结核合并症患者治疗依从性及治疗结局影响因素分析[J].中国防痨杂志,2025,47(10):1268-1278. [14] Gebrie E,Baynes H W,Mulugeta B,et al.Sex hormones and tuberculosis:implications for immune regulation,susceptibility,and disease pathogenesis[J/OL].Tuberculosis(Edinb),2026,157[2026-08-25].http://doi.org/10.1016/j.tube.2026.102740. [15] 周旭,王巧智,万燕萍,等.衡阳市成功治疗的肺结核患者5年复发影响因素分析[J].预防医学,2022,34(3):268-271. [16] 陈松华,张钰,刘魁,等.新发肺结核病患者成功治疗后发病重新登记情况的跟踪研究[J].疾病监测,2023,38(11):1301-1306. [17] 黄珊珊,董小伟,周芳静,等.广东省肺结核患者复发流行特征及其影响因素分析[J].中国防痨杂志,2026,48(1):41-48. [18] Jiang H,Yin J F,Liu F C,et al.Epidemiology of recurrent pulmonary tuberculosis by bacteriological features of 100 million residents in China[J/OL].BMC Infect Dis,2022,22(1)[2026-08-25].http://doi.org/10.1186/s12879-022-07622-w. |
|
|
|