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目的探讨影响初治肺结核患者转归的因素。方法广州市番禺区慢性病防治站结核科2013年1月~9月登记治疗的597例初治肺结核患者,包括280例涂阳、317例涂阴患者。评价初治肺结核转归的指标是2月痰阴转、病灶吸收、空洞闭合。相关因素包括:年龄、性别、病变情况(是否有空洞、病变范围),生活习惯(吸烟、饮酒),糖尿病,营养状况(BMI、是否贫血、低蛋白血症),一般情况(临床症状≥3项、有否住院、就诊延迟、体重变化、CRP、TBAb、PPD检查)。数据均通过SPSS统计软件处理,采用Logistic多因素分析,分析影响初治肺结核转归的因素。结果影响初治肺结核患者转归、有统计学意义的因素有糖尿病(χ2=14.666,P=0.000)、、体重变化(χ2=7.039,P=0.008),,病变范围(χ2=82.906,P=0.000),CRP(χ2=138.472,P=0.000),TBAb(χ2=10.052,P=0.002)。而营养状况(BMI、是否贫血、低蛋白血症)、生活习惯(吸烟、饮酒)、性别、年龄,一般情况(临床症状≥3项、有否住院、就诊延迟、PPD检查)均无统计学意义(P>0.05)。结论体重减轻5kg以上、病变范围4肺野及以上、糖尿病患者、CRP大于5mg/L,TBAb阳性等因素对初治肺结核患者转归有明显影响。
Objective To explore the factors influencing the prognosis of patients with newly diagnosed pulmonary tuberculosis. Methods A total of 597 newly diagnosed tuberculosis patients were enrolled in the TB department of Panyu District, Guangzhou City, from January to September 2013, including 280 smear positive patients and 317 smear negative patients. Evaluation of the outcome of the initial treatment of tuberculosis index is sputum yin turn in February, the lesion absorption, empty closed. Relevant factors include age, sex, disease status (whether there are emphysema, extent of disease), lifestyle (smoking, drinking), diabetes, nutritional status (BMI, anemia, hypoproteinemia), general condition Term, hospitalized, delayed treatment, weight change, CRP, TBAb, PPD). The data were processed by SPSS statistical software, using Logistic multivariate analysis to analyze the factors influencing the outcome of newly diagnosed tuberculosis. Results The prognosis of patients with newly diagnosed pulmonary tuberculosis was statistically significant with diabetes (χ2 = 14.666, P = 0.000), body weight change (χ2 = 7.039, P = 0.008) 0.000), CRP (χ2 = 138.472, P = 0.000), TBAb (χ2 = 10.052, P = 0.002). Nutritional status (BMI, anemia, hypoalbuminemia), lifestyle (smoking, drinking), sex, age, general condition (clinical symptoms≥3 items, hospitalization, delayed treatment and PPD) were not statistically significant Significance (P> 0.05). Conclusion The body weight loss of more than 5kg, the lesion range of 4 lung fields and above, diabetic patients, CRP greater than 5mg / L, TBAb positive and other factors have significant impact on the outcome of primary tuberculosis patients.