2015－2019年青海省老年肺结核患者治疗转归及影响因素

马斌忠; 赵晓银; 王朝才; 杨世泽; 魏於家; 李尔琛

doi:10.3784/jbjc.20208020340

2015－2019年青海省老年肺结核患者治疗转归及影响因素

Treatment outcome and influencing factors of elderly pulmonary tuberculosis patients in Qinghai province from 2015 to 2019

摘要

摘要:
目的分析青海省老年肺结核患者治疗转归情况及影响因素，为青海省老年肺结核的防治提供科学依据。
方法从《全国结核病管理信息系统》导出2015—2019年青海省老年肺结核患者信息，回顾性分析其治疗转归现状，用单因素χ²检验和非条件多因素logistic回归分析影响老年肺结核治疗转归的因素。
结果 2015—2019年青海省共报告老年肺结核8 156例，治疗成功7 319例，治疗成功率为89.74%，呈上升趋势（趋势χ² =9.141，P<0.05）。非条件多因素logistic回归分析结果显示，藏族［比值比（OR）=1.456, 95%置信区间（CI）: 1.163～1.823）］、其他少数民族（OR=1.600, 95%CI: 1.299～1.971）、其他健康检查（OR=6.082, 95%CI: 1.449～25.523）、非重症患者（OR=1.830, 95%CI: 1.282～2.613）、全程管理（OR=2.523, 95%CI:1.568～4.060）、初治患者（OR=2.111, 95%CI: 1.504～2.964）治疗成功率较高；男性（OR=0.711, 95%CI: 0.609～0.83）、70～80岁年龄组（OR=0.620, 95%CI: 0.53～0.725）、>80岁年龄组（OR=0.450, 95%CI: 0.325～0.622）、因症推荐（OR=0.481, 95%CI: 0.315～0.734）、转诊（OR=0.736, 95%CI: 0.610～0.888）、非系统管理（OR=0.065, 95%CI: 0.047～0.090）、病原学阳性（OR=0.567, 95%CI: 0.478～0.671）、首诊断单位为县级（OR=0.546, 95%CI: 0.342～0.873）患者治疗成功率较低，差异均有统计学意义（均P<0.05）。
结论 2015—2019年青海省老年肺结核治疗成功率低于全省总人群治疗成功率，但是呈上升趋势；应重点关注老年男性、高年龄组、汉族、患者来源为因症推荐、转诊到位的患者、重症患者、自服药、非系统管理、复治、病原学阳性、首诊断单位级别为县级的患者。

Abstract:
Objective To analyze the treatment outcome and influencing factors of elderly pulmonary tuberculosis(PTB) patients in Qinghai province, to provide scientific basis for elderly PTB prevention and treatment in Qinghai province.
Methods The elderly PTB patients status treatment outcome was retrospectively studied in Qinghai province from 2015 to 2019, which was downloaded from the National Tuberculosis Management Information System. The influencing factors were analyzed by univariate χ² test and unconditional multivariate logistic regression.
Results 8 156 elderly PTB patients were reported in Qinghai province from 2015 to 2019, and 7 319 patients were successfully treated, the successful treatment rate showed an increasing trend (trendχ²=9.141, P<0.05). Unconditional multivariate logistic regression analysis showed that Tibetan (OR=1.456, 95%CI: 1.163–1.823), other minorities (OR=1.600, 95%CI: 1.299–1.971), other health examinations (OR=6.082, 95%CI: 1.449–25.523), non-severe patients (OR=1.830, 95%CI: 1.282–2.613), whole-course management (OR=2.523, 95%CI: 1.568–4.060), and newly treated patients (OR=2.111, 95%CI: 1.504–2.964) showed higher success successful treatment rates. Male (OR=0.711, 95%CI: 0.609–0.830), 70–80 years old age group (OR=0.620, 95%CI: 0.530–0.725), >80 year old group (OR=0.450, 95%CI: 0.325–0.622), syndrome recommendation (OR=0.481, 95%CI: 0.315–0.734), referral (OR=0.736, 95%CI: 0.610–0.888), non-systematic management (OR=0.065, 95%CI: 0.047–0.090), positive etiology (OR=0.567, 95%CI: 0.478–0.671), county level as the first diagnostic unit (OR=0.546, 95%CI: 0.342–0.873) patients showed lower successful treatment rates, and the differences were statistically significant (all P<0.05).
Conclusion The elderly PTB successful treatment rate in Qinghai province was lower than whole population’s, but showed an increasing trend. More Attention should be paid to elderly, older age groups, Han nationality, patients with syndrome recommendation, referral, severe patients, self-medication, non-systematic management, re-treatment, positive etiology, and county level as the first diagnostic unit.

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