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目的了解结核病人治疗的依从性以及影响治疗依从性的社会经济及临床影响因素。方法以2003年6月1日至2005年5月31日的330例初治和143例复治肺结核病人作为研究对象,进行治疗期2个月末、5个月末和治疗结束的随访问卷调查。结果初治和复治病人2个月治疗依从率分别为90.0%和84.6%,全程治疗依从率分别为90.0%和79.7%。BMI指数、出现副作用和药品费用影响常住病人抗结核治疗的依从性。随着BMI指数的升高,结核病人更倾向于依从抗结核治疗(OR=1.21,P=0.035);出现副作用的结核病人依从性差于无副作用病人(OR=0.14,P=0.020);在治疗过程中支付较低费用的病人依从性优于最高费用组(OR=44.52,P=0.038)。结论灌云县结核病的治疗具有较高的依从率,初治病人的治疗依从性高于复治病人,药物副作用和由此引发的医疗费用正成为该地区结核病治疗依从的障碍。
Objective To understand the treatment compliance of TB patients and the socioeconomic and clinical influencing factors of treatment adherence. Methods 330 cases of newly diagnosed and 143 cases of re-treatment of pulmonary tuberculosis from June 1, 2003 to May 31, 2005 were enrolled in this study. The follow-up questionnaires of 2 months, 5 months and the end of treatment were included in the study. Results The two-month follow-up rates of initial treatment and re-treatment were 90.0% and 84.6% respectively, and the compliance rate of the whole treatment was 90.0% and 79.7% respectively. BMI index, side effects and drug costs affect the compliance of anti-TB treatment in elderly patients. TB patients were more likely to follow anti-TB treatment (OR = 1.21, P = 0.035) with increasing BMI index; those with adverse reactions had worse compliance than those without side effects (OR = 0.14, P = 0.020) Patients who paid less for the course had better adherence than the highest cost group (OR = 44.52, P = 0.038). Conclusions Guanyun TB treatment has a high compliance rate. The treatment compliance of newly diagnosed patients is higher than that of re-treatment patients. The drug side effects and the medical expenses caused by TB are becoming barriers to TB compliance in the region.