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黄莉, 许琳, 杨蕊, 侯景龙, 张丽芳. 云南省2010—2013年HIV阳性结核病患者抗结核疗效影响因素[J]. 中国公共卫生, 2017, 33(3): 357-360. DOI: 10.11847/zgggws2017-33-03-04
引用本文: 黄莉, 许琳, 杨蕊, 侯景龙, 张丽芳. 云南省2010—2013年HIV阳性结核病患者抗结核疗效影响因素[J]. 中国公共卫生, 2017, 33(3): 357-360. DOI: 10.11847/zgggws2017-33-03-04
HUANG Li, XU Lin, YANG Rui.et al, . Influencing factors of anti-tuberculosis treatment among HIV-positive TB patients in Yunnan province,2010-2013[J]. Chinese Journal of Public Health, 2017, 33(3): 357-360. DOI: 10.11847/zgggws2017-33-03-04
Citation: HUANG Li, XU Lin, YANG Rui.et al, . Influencing factors of anti-tuberculosis treatment among HIV-positive TB patients in Yunnan province,2010-2013[J]. Chinese Journal of Public Health, 2017, 33(3): 357-360. DOI: 10.11847/zgggws2017-33-03-04

云南省2010—2013年HIV阳性结核病患者抗结核疗效影响因素

Influencing factors of anti-tuberculosis treatment among HIV-positive TB patients in Yunnan province,2010-2013

  • 摘要: 目的分析云南省人类免疫缺陷病毒(HIV)阳性结核病(TB)患者抗结核疗效的影响因素。方法利用TB/HIV双重感染防治监控评价体系,分析云南省2010—2013年登记TB患者HIV抗体检测结果,比较HIV阳性TB患者和HIV阴性TB患者的特征及抗结核治疗效果。数据采用单因素χ2检验,筛选有影响变量进入多因素logistic回归模型,分析影响HIV阳性TB患者治疗成功的因素。结果共登记报告HIV检测阳性TB患者1 526例,HIV阴性TB患者51 838例。与HIV阴性患者比较,HIV阳性TB患者痰涂片阴性比例较高(67.96% vs 56.00%,χ2=327.54,P<0.001),复治比例较高(22.87% vs 3.69%,χ2=1 342.6,P<0.001)、治疗成功率较低(88.07% vs 95.81%,χ2=210.08,P<0.001)、非结核死亡率较高(5.77% vs 0.61%,χ2=524.73,P<0.001);诊断肺结核时CD4<200 个/μL 和治疗分类为复治是影响HIV阳性患者抗结核疗效的危险因素。结论及早发现HIV阳性TB患者,结合其CD4水平及时提供抗结核治疗,加强患者随访管理。

     

    Abstract: ObjectiveTo examine influence factors of anti-tuberculosis (anti-TB) treatment among human immunodeficiency virus (HIV)-positive TB patients in Yunnan province.MethodsWe collected relevant data from Yunnan Provincial TB/HIV Information Management System and selected TB cases with HIV test results registered between 2010 and 2013.We compared clinic characteristics of TB and outcome of anti-TB treatment between the HIV-positive and HIV-negative TB patients.We used anti-TB treatment outcome as a dependent variable and 15 possible factors as independent variables and conducted chi-square test and multivariate logistic regression to analyze related factors of effective anti-TB treatment for HIV-positive TB patients.ResultsWe analyzed the data for a total of 53 364 registered TB cases during a 4-year period and identified 5 126 HIV-positive and 51 838 HIV-negative cases.Compared to the HIV-negative cases,HIV-positive cases had a higher percentage of sputum smear negative (67.96% vs.56.00%,χ2=327.54;P<0.001),higher percentage of retreatment (22.87% vs.3.69%,χ2=1342.6;P<0.001),lower percentage of successful treatment (88.07% vs.95.81%,χ2=210.08;P<0.001),and higher percentage of non-TB related death (5.77% vs.0.61%,χ2=524.73;P<0.001).The TB patients with CD4<200 and retreatment cases had a higher risk of unsuccessful anti-TB treatment.ConclusionTo detect HIV-positive TB patients earlier and to implement anti-TB treatment in time,as well as to strengthen the supervision during treatment and to avoid retreatment could improve anti-TB treatment outcome among HIV-positive TB patients.

     

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