【摘要】

摘要：目的 探讨初治耐多药肺结核患者抗结核治疗后疗效的影响因素。
方法 回顾性分析2016年5月～2018年5月收治的150例初治耐多药肺结核患者的临床资料，所有患者均进行抗结核治疗。根据抗结核治疗效果，将其分成预后良好组与预后不良组。比较两组患者的临床特征，包括性别、年龄、病程、体质指数、吸烟史、饮酒史、不良反应、使用二线药物、定期复查、漏服药、血红蛋白、白蛋白情况，便于分析抗结核治疗疗效与临床特征的关系。采用logistic回归模型分析抗结核治疗后疗效的影响因素。
结果 在150例患者中，治愈78例，占52.00%，完成治疗41例，占27.33%，无效28例，占18.67%，死亡3例，占2.00%。预后不良组年龄≥65岁、有不良反应、使用二线药物、低血红蛋白血症、低白蛋白血症、不定期复查、漏服药占比分别为61.29%、45.16%、51.61%、45.16%、54.84%、19.35%、22.58%，均高于预后良好组的36.97%、19.33%、25.21%、22.69%、23.53%、4.20%、8.40%，差异有统计学意义（P<0.05）。经logistic回归性分析提示年龄≥65岁、有不良反应、使用二线药物、低血红蛋白血症、低白蛋白血症、不定期复查、漏服药是患者抗结核治疗后预后不良的独立危险因素（P<0.05）。
结论 初治耐多药肺结核患者抗结核治疗效果主要与年龄、不良反应、使用二线药物、低血红蛋白血症、低白蛋白血症、不定期复查、漏服药存在关联，临床需对此引起重视。

【Abstract】

Abstract Objective To investigate the factors influencing the efficacy of anti tuberculosis treatment in newly diagnosed multi drug resistant pulmonary tuberculosis patients.
Methods A retrospective analysis was made on the clinical data of 150 patients with MDR-TB who were treated from May 2016 to May 2018.According to the effect of anti tuberculosis treatment, the patients were divided into good prognosis group and poor prognosis group.The clinical characteristics of the two groups were compared, including sex, age, course of disease, body mass index, smoking history, drinking history, adverse reactions, second-line drugs, regular review, omission of drugs, hemoglobin, albumin, so as to analyze the relationship between the efficacy of anti-tuberculosis treatment and clinical characteristics.Logistic regression model was used to analyze the influencing factors of the efficacy after antituberculous treatment.
Results Of the 150 patients, 78 were cured, accounting for 52.00%, 41 were treated, accounting for 27.33%, 28 were ineffective, accounting for 18.67%, and 3 died, accounting for 2.00%.The proportions of patients with poor prognosis were 61.29%, 45.16%, 51.61%, 45.16%, 54.84%, 19.35% and 22.58% respectively, which were higher than those of patients with good prognosis (36.97%, 19.33%, 25.21%, 22.69%, 23.53%, 4.20%, 8.40%)(P < 0.05).Logistic regression analysis showed that age (> 65 years), adverse reactions, second-line drug use, hypohemoglobinemia, hypoalbuminemia, irregular review, omission of medication were independent risk factors for poor prognosis after anti-tuberculosis treatment (P < 0.05).
Conclusion   The anti-tuberculosis effect of newly treated multi-drug resistant pulmonary tuberculosis patients is mainly related to age, adverse reactions, second-line drug use, hypohemoglobinemia, hypoalbuminemia, irregular review, omission of medication, which should be paid attention to clinically.