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目的:确定结核病人的完成治疗情况,并分析中断治疗和病死的相关因素。方法:在 SEPAR 结核病和呼吸道感染工作组成员工作的地区,对 1999 年 6 月 1 日至2000 年5 月 31 日期间开始接受治疗的结核病人进行前瞻性队列分析。利用 logistic 回归对与中断治疗和病死相关的诸因素进行了研究,并计算各因素的比数比(OR)及其 95%CI。结果:本项研究涉及 76 家医院 142 名医生提供的1515 例病例信息。82%的病人完成了全部治疗,14%中断治疗,5%死亡,0.5%治疗失败,8.7%由于迁出或其它原因中断了治疗。与中断治疗有关的变量是静脉吸毒(IVDU)(OR=6.00,95%CI:2.59-13.89和移民(OR=8.57,95%CI:3.78-19.45);性别、年龄、无家可归、监禁、DOT或住院治疗与中断治疗无关。病人病死率的预报因素有酗酒(OR=6.38,95%CI:2.09-19.48);HIV 感染(OR=7.08,95%CI:2.08-29.15)和年龄大于 64 岁(OR=10,95%CI:2.9-34.07),性别、吸毒、无家可归、DOT 和住院治疗与病人的病死率无关。结论:在发达国家应对吸毒和移民病人采用 DOT,另外,需要对酗酒、HIV 感染、年龄大于64 岁者实施严格监督以降低其病死率。
OBJECTIVE: To determine the completion of treatment of tuberculosis patients, and analyze the factors related to the interruption of treatment and death. Methods: In a prospective cohort of tuberculosis patients who started treatment between June 1, 1999 and May 31, 2000, in the area where members of the SEPAR Tuberculosis and Respiratory Infection Task Force work. Factors associated with discontinuation of treatment and death were studied using logistic regression and the odds ratio (OR) and 95% CI of each factor were calculated. Results: This study involved 1,515 case information provided by 142 doctors in 76 hospitals. 82% completed the entire treatment, 14% discontinued treatment, 5% died, 0.5% failed treatment, and 8.7% discontinued treatment due to removal or other causes. The variables associated with discontinuation of treatment were intravenous drug use (IVDU) (OR = 6.00, 95% CI: 2.59-13.89 and immigrants (OR = 8.57, 95% CI: 3.78-19.45; sex, age, homelessness, incarceration (OR = 6.38, 95% CI: 2.09-19.48), HIV infection (OR = 7.08, 95% CI: 2.08-29.15), and age greater than 64 years old (OR = 10, 95% CI: 2.9-34.07), gender, drug addiction, homelessness, DOT and hospitalization were not related to the patient’s mortality.Conclusion: DOT should be used in drug treatment and immigrant patients in developed countries , There is a need to exercise strict supervision over alcoholism, HIV infection and those over the age of 64 in order to reduce their mortality.