| 曹军燕,陆真惠,来洁,陈莉贞.继发性肺结核涂（培）阳初治患者治愈后复发情况及其相关危险因素分析[J].浙江中西医结合杂志,2025,35(5): |
| 继发性肺结核涂（培）阳初治患者治愈后复发情况及其相关危险因素分析 |
| Analysis of Recurrence and Related Risk Factors in Patients with Secondary Pulmonary Tuberculosis who were Sputum (Culture) Positive at Initial Treatment After Cure |
| 投稿时间：2024-06-15 修订日期：2025-01-09 |
| DOI： |
| 中文关键词: 肺结核 初治 涂阳 治愈 复发 危险因素 |
| 英文关键词:Pulmonary tuberculosis Newly treated Smear-positive Cure Recurrence Risk factors |
| 基金项目:百合固金汤加减联合免疫肠内营养对重症肺结核阴虚火旺型细胞免疫水平及临床疗效的影响分析 |
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| 中文摘要: |
| 目的 探讨继发性肺结核涂（培）阳初治患者治愈后复发情况及其相关危险因素。方法 回顾性分析360例2018年1月~2020年1月于我院接受抗结核治疗并治愈的继发性肺结核涂（培）阳初治患者的临床资料，根据所选患者治愈后随访期间是否复发将其分为复发组和未复发组。收集患者的临床资料，包括年龄、性别、BMI、治疗单位级别、是否伴有吸烟史、职业、诊断延误时间、是否被动就诊、停药时有无残留肺部空洞、有无耐药、是否合并糖尿病等，采用多因素Logistic回归分析法分析治愈后复发的危险因素。结果 360例继发性肺结核涂（培）阳初治患者治愈后复发率为6.94%（25/360）。单因素分析发现，复发组与未复发组年龄、职业、诊断延误时间、是否被动就诊、停药时有无残留肺部空洞、有无耐药比较，差异具有统计学意义（p<0.05）。多因素Logistic回归分析发现，年龄≥60岁、职业为体力型、被动就诊、停药时有残留肺部空洞、有耐药均是继发性肺结核涂（培）阳初治患者治愈后复发的独立危险因素（OR=3.497、3.785、4.740、4.129、3.885，p＜0.05）。结论 继发性肺结核涂（培）阳初治患者治愈后复发率较高，且其复发的危险因素包括年龄≥60岁、职业为体力型、被动就诊、停药时有残留肺部空洞、有耐药等，临床可据此予以患者治疗及干预，降低继发性肺结核涂（培）阳初治患者治愈后复发风险。 |
| 英文摘要: |
| Objective: To investigate the recurrence and its associated risk factors in patients with secondary pulmonary tuberculosis who were sputum (culture) positive at initial treatment after cure. Methods: A retrospective analysis was conducted on the clinical data of 360 patients treated for secondary pulmonary tuberculosis who were sputum (culture) positive at initial treatment and cured in our hospital from January 2018 to January 2020. Patients were divided into the recurrence group (25 cases) and the non-recurrence group (335 cases) based on whether they relapsed within two years after cure. The recurrence situation and its univariate factors were statistically analyzed, and multivariate logistic regression was used to analyze the risk factors for recurrence. Results: The recurrence rate among the 360 patients was 6.94% (25/360). Univariate analysis showed significant differences between the recurrence and non-recurrence groups in terms of age, occupation, diagnostic delay, passive healthcare seeking, presence of residual pulmonary cavities at the end of treatment, and resistance (P<0.05). Multivariate logistic regression revealed that age ≥60 years, physically demanding occupations, passive healthcare seeking, residual pulmonary cavities at the end of treatment, and resistance were independent risk factors for recurrence (OR=3.497, 3.785, 4.740, 4.129, 3.885; P＜0.05). Conclusion: The recurrence rate in patients with secondary pulmonary tuberculosis who were sputum (culture) positive at initial treatment is relatively high, and risk factors include age ≥60 years, physically demanding occupations, passive healthcare seeking, residual pulmonary cavities at the end of treatment, and resistance. Clinical interventions should be based on these factors to reduce the risk of recurrence in these patients. |
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