惠安县涂阳肺结核患者二线抗结核药物使用及影响因素分析
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摘要
目的了解2010~2012年惠安县疾病预防控制中心结核门诊涂阳肺结核患者二线抗结核药物(secondline antituberculosis durgs,SLD)使用情况,为该县制定合理使用SLD提供参考资料。方法应用自行设计的《惠安县登记治疗肺结核患者信息调查表》,根据2010~2012年惠安县疾病预防控制中心涂阳结核病患者病案资料进行回顾性调查,对患者基本情况、SLD使用情况及影响因素进行分析。结果初治患者741例,复治患者116例,使用SLD肺结核患者治疗成功率为79.88%,未使用SLD肺结核患者治疗成功率为87.15%,两者的差异有统计学意义(P<0.01);影响SLD使用的因素为X线有无空洞、治疗分类、病变部位涉及肺野严重程度和性别(均有P<0.05)。结论涂阳肺结核患者在未进行药敏试验或者结果未报告之前,应该选择标准的化疗方案进行治疗,避免不规范使用二线抗结核药物(SLD)。
Objective To understand the information about using second line anti- tuberculosis drugs in smear positive pulmonary tuberculosis cases in Huian county,and provide evidence for policies about using SLD. Methods Using the united questionnaire to retrospectively investigate the smear positive pulmonary tuberculosis cases in Huian county from 2010 to 2012. We analyzed the cases data,information of SLD use and affecting factors. Results A total of 741 patients were new cases and 116 were retreated cases. The successful treatment rate of pulmonary tuberculosis cases using SLD was 79.88%,and that of cases without SLD was 87. 15%,which showed statistical significance between the two rates. The factors affecting the use of SLD were pulmonary cavity in X ray,therapeutic classification,lesions locus in lung field and sex( P <0. 05). Conclusion The smear positive TB cases should be treated with the standard regimen before the DST or waiting the results,in order to avoid irregularly use of SLD.
Objective To understand the information about using second line anti- tuberculosis drugs in smear positive pulmonary tuberculosis cases in Huian county,and provide evidence for policies about using SLD. Methods Using the united questionnaire to retrospectively investigate the smear positive pulmonary tuberculosis cases in Huian county from 2010 to 2012. We analyzed the cases data,information of SLD use and affecting factors. Results A total of 741 patients were new cases and 116 were retreated cases. The successful treatment rate of pulmonary tuberculosis cases using SLD was 79.88%,and that of cases without SLD was 87. 15%,which showed statistical significance between the two rates. The factors affecting the use of SLD were pulmonary cavity in X ray,therapeutic classification,lesions locus in lung field and sex( P <0. 05). Conclusion The smear positive TB cases should be treated with the standard regimen before the DST or waiting the results,in order to avoid irregularly use of SLD.
引文
[1]蔡纪明,陈贤义.中国结核病控制工作典范--世界银行贷款传染病与地方病控制项目结核病控制部分终期评价报告[M].北京:人民卫生出版社,2003.17
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[2]屠德华.肺结核化学治疗中标准化方案与个体化方案的应用[J].中华结核和呼吸杂志,2004,27(2):75-76.
[3]陈伟,王雪静,王黎霞,等.全国五省结核病与性别关系的研究[J].中国防痨杂志,2010,32(9):534-539.
[4]胡远莲,何广学,刘志敏,等.我国SLD使用现状调查研究[J].中国防痨杂志,2010,32(11):706-709.
[5]李文婧,孙强,闫赟,等.结核病专科医院和结防机构SLD使用现状调查[J].中国防痨杂志,2010,32(3):123-128.
[6]Ben Amor Y,Day MS,Schluger NW.Preventing the next generation of extensively drug-resistant tuberculosis[J].Int J Tuberc Lung Dis,2010,14(5):525-527.
[7]Shah NS,Pratt R,Armstrong L.et al.Extensively drug-resistant tuberculosis in the United States,1993-2007[J].JAMA,2008,300(18):2153-2160.