我国耐多药结核患者治疗依从性影响因素meta分析
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摘要
目的系统评价耐多药结核患者治疗依从性的影响因素,为改善患者治疗依从性,提高治疗成功率提供依据。方法系统检索万方医学数据库、中国知网(China National Knowledge Infrastructure,CNKI)、中国生物医学文献数据库(Chinese Biological and Medical Database,CBM)中发表的耐多药结核患者治疗依从性影响因素的文献,采用Rev Man 5.3软件对纳入文献进行系统分析,包括异质性检验,计算各影响因素OR值及95%可信区间。结果共纳入文献14篇,meta分析结果显示,患者年龄、性别、文化程度、交通状况、病例来源、治疗经过对患者治疗依从性的影响没有统计学意义(P>0.05),患者疾病知晓率、经济状况及药物不良反应对依从性的影响有统计学意义(P<0.05),合并OR值和95%CI分别为3.26 (2.52～4.23)、2.80(1.61～4.86)和3.85(2.34～6.32)。结论影响患者治疗依从性的主要因素分别是患者的结核知晓率、经济条件、药物不良反应等因素。
Objective To systematically evaluate the factors influencing treatment compliance of patients with multidrug-resistant tuberculosis(MDR-TB) in China, and to provide a basis for improving their treatment compliance and increasing the successful rate of therapy. Methods Literatures relevant to the factors influencing treatment compliance of MDR-TB patients were searched online through Wanfang Database, China National Knowledge Infrastructure(CNKI), and Chinese Biological and Medical Database(CBM). RevMan 5.3 software was used to perform a meta-analysis, including conducting the heterogeneity test and caculating the OR value and 95% confidence interval(CI)of each influencing factor. Results A total of 14 literatures were collected. The results of meta-analysis showed that there was no statistically significant difference in treatment compliance affected by patients' age, sex, education background, traffic status, sources of cases and treatment process(P>0.05), but statistically significant difference was found in treatment compliance affected by patients' disease awareness rate(OR=3.26, 95%CI:2.52-4.23), economic situation(OR=2.80, 95%CI:1.61-4.86) and adverse drug reactions(OR=3.85, 95%CI:2.34-6.32),(all P<0.05). Conclusions The main factors influencing the patients' treatment compliance are awareness rate of tuberculosis, economic status and adverse drug reactions.
Objective To systematically evaluate the factors influencing treatment compliance of patients with multidrug-resistant tuberculosis(MDR-TB) in China, and to provide a basis for improving their treatment compliance and increasing the successful rate of therapy. Methods Literatures relevant to the factors influencing treatment compliance of MDR-TB patients were searched online through Wanfang Database, China National Knowledge Infrastructure(CNKI), and Chinese Biological and Medical Database(CBM). RevMan 5.3 software was used to perform a meta-analysis, including conducting the heterogeneity test and caculating the OR value and 95% confidence interval(CI)of each influencing factor. Results A total of 14 literatures were collected. The results of meta-analysis showed that there was no statistically significant difference in treatment compliance affected by patients' age, sex, education background, traffic status, sources of cases and treatment process(P>0.05), but statistically significant difference was found in treatment compliance affected by patients' disease awareness rate(OR=3.26, 95%CI:2.52-4.23), economic situation(OR=2.80, 95%CI:1.61-4.86) and adverse drug reactions(OR=3.85, 95%CI:2.34-6.32),(all P<0.05). Conclusions The main factors influencing the patients' treatment compliance are awareness rate of tuberculosis, economic status and adverse drug reactions.
引文
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[8] 沈轶群,张艳.对氨水杨酸颗粒剂治疗耐多药肺结核的依从性分析及心理干预[J].实用药物与临床,2013,16(10):929-930.
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[11] 郝宝林,刘占峰,马丽萍.98例耐多药结核病患者治疗管理依从性单因素分析[J].河南预防医学杂志,2014,25(4):241-243,257.
[12] 肖钦,林宪和.167例MDR-TB患者规则服药依从性及影响因素[J].海峡预防医学杂志,2015,21(5):36-37.
[13] 李艳红,吴江贵,周桂芝,等.耐多药结核病患者治疗依从性的影响因素分析[J].中国感染控制杂志,2015,14(9):593-596.
[14] 钱林美.耐多药结核患者治疗依从性的影响因素和对策的研究[J].中外医疗,2015,(22):91-92.
[15] 任淑君.耐多药结核病患者出院后治疗依从性的影响因素调查研究[J].中国卫生标准管理,2016,7(12):26-27.
[16] 马丙乾.89例耐多药肺结核患者治疗依从性调查分析[J].结核病与肺部健康杂志,2016,5(1):54-57.
[17] 秦志华,施军卫,邱青,等.195例耐多药肺结核患者治疗依从性及影响因素分析[J].结核病与肺部健康杂志,2016,5(4):283-287.
[18] 肖东楼.中国结核病防治工作进展与成就[J].中国防痨杂志,2008,30(6):491-493.
[19] 全国第五次结核病流行病学抽样调查技术指导组,全国第五次结核病流行病学抽样调查办公室.2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34(8):485-508.
[20] 郑超峰,甄新安.河南省结核菌耐多药状况分析[J].河南预防医学杂志,2017,28(7):514-515.
[21] 喻容,石国民,马小华,等.2014年长沙市155株耐多药结核分枝杆菌耐药结果分析[J].实用预防医学,2016,23(7):777-779.
[22] 成诗明,刘二勇,王芳,等.现代结核病控制策略的实施进展及系统评价[J].中国防痨杂志,2012,34(9):585-591.
[23] 孙福红,魏水易,许自明,等.随机对照试验meta分析的质量评价[J].药物流行病学杂志,2002,11(1):31-36.
[24] 国务院办公厅.全国结核病防治规划(2011-2015年)[J].中国实用乡村医生杂志,2012,19(3):1-3.
[25] 苏宁,朱瑞,于建平,等.北京市涂阳肺结核患者健康教育效果分析[J].实用预防医学,2017,24(3):265-268.
[2] 边学峰.中国耐多药结核病防治体系现状、问题与对策研究[D].济南:山东大学,2011.
[3] 肖和平.耐多药结核病化学治疗指南[M].北京:人民卫生出版社,2010:49-58.
[4] 李明虎,孙谨芳.耐多药结核病患者治疗管理依从性影响因素分析[J].中国防痨杂志,2009,31(10):617-618.
[5] 李华平,杨坤云.耐多药肺结核病人治疗依从性分析及干预对策[J].实用预防医学,2009,16(5):1559-1561.
[6] 杨坤云,易恒仲,唐志冈,等.78例耐多药肺结核患者治疗依从性分析[J].实用预防医学,2012,19(6):846-847.
[7] 何平平,李东霞.52例住院耐多药肺结核患者服药依从性影响因素分析[J].中国临床医生,2013,41(3):45-46.
[8] 沈轶群,张艳.对氨水杨酸颗粒剂治疗耐多药肺结核的依从性分析及心理干预[J].实用药物与临床,2013,16(10):929-930.
[9] 张俊萍.太原市西山矿区耐多药结核病患者依从性影响因素分析[J].实用医技杂志,2013,20(7):719-720.
[10] 郑岚.湖南省结核病医院耐多药肺结核患者治疗依从性及其影响因素研究[D].长沙:中南大学,2013.
[11] 郝宝林,刘占峰,马丽萍.98例耐多药结核病患者治疗管理依从性单因素分析[J].河南预防医学杂志,2014,25(4):241-243,257.
[12] 肖钦,林宪和.167例MDR-TB患者规则服药依从性及影响因素[J].海峡预防医学杂志,2015,21(5):36-37.
[13] 李艳红,吴江贵,周桂芝,等.耐多药结核病患者治疗依从性的影响因素分析[J].中国感染控制杂志,2015,14(9):593-596.
[14] 钱林美.耐多药结核患者治疗依从性的影响因素和对策的研究[J].中外医疗,2015,(22):91-92.
[15] 任淑君.耐多药结核病患者出院后治疗依从性的影响因素调查研究[J].中国卫生标准管理,2016,7(12):26-27.
[16] 马丙乾.89例耐多药肺结核患者治疗依从性调查分析[J].结核病与肺部健康杂志,2016,5(1):54-57.
[17] 秦志华,施军卫,邱青,等.195例耐多药肺结核患者治疗依从性及影响因素分析[J].结核病与肺部健康杂志,2016,5(4):283-287.
[18] 肖东楼.中国结核病防治工作进展与成就[J].中国防痨杂志,2008,30(6):491-493.
[19] 全国第五次结核病流行病学抽样调查技术指导组,全国第五次结核病流行病学抽样调查办公室.2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34(8):485-508.
[20] 郑超峰,甄新安.河南省结核菌耐多药状况分析[J].河南预防医学杂志,2017,28(7):514-515.
[21] 喻容,石国民,马小华,等.2014年长沙市155株耐多药结核分枝杆菌耐药结果分析[J].实用预防医学,2016,23(7):777-779.
[22] 成诗明,刘二勇,王芳,等.现代结核病控制策略的实施进展及系统评价[J].中国防痨杂志,2012,34(9):585-591.
[23] 孙福红,魏水易,许自明,等.随机对照试验meta分析的质量评价[J].药物流行病学杂志,2002,11(1):31-36.
[24] 国务院办公厅.全国结核病防治规划(2011-2015年)[J].中国实用乡村医生杂志,2012,19(3):1-3.
[25] 苏宁,朱瑞,于建平,等.北京市涂阳肺结核患者健康教育效果分析[J].实用预防医学,2017,24(3):265-268.