肺结核患者不良治疗结局的危险因素分析
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张登莲
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云南省昭通市巧家县人民医院，云南昭通，654600
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摘要：目的：探讨影响肺结核患者不良治疗结局的主要危险因素，为提高治疗效果、改善患者预后提供依据。方法：回顾性分析本院2023年10月—2024年10月期间收治的54例肺结核患者，根据治疗结局分为治疗良好组（n=32）与不良结局组（n=22）。不良结局包括治疗失败、复发、中断治疗及病情进展等。收集患者的人口学特征、吸烟饮酒史、体重指数（BMI）、病程、合并症、肺部病灶范围、有无空洞形成、用药依从性及不良反应等信息，采用Logistic回归模型分析影响治疗结局的独立危险因素。结果：与治疗良好组相比，不良结局组患者更常见男性、有吸烟史、合并其他慢性疾病、BMI水平偏低、肺部空洞形成、肺叶病灶数≥3个以及治疗依从性差等情况。Logistic回归分析显示，吸烟史、合并症、低BMI、空洞形成和肺野病灶多（≥3个）为不良治疗结局的独立危险因素（P＜0.05），而治疗依从性良好为保护因素（P＜0.05）。结论：吸烟、体形消瘦、合并症、病灶范围广和空洞形成是肺结核不良治疗结局的高危因素，规律抗结核治疗可有效改善预后，临床应针对高危个体加强干预和随访管理。
关健词：肺结核；治疗结局；影响因素 |
Analysis of Risk Factors for Adverse treatment outcomes in patients with Pulmonary tuberculosis
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Denglian Zhang
Qiaojia County People's Hospital, Zhaotong City, Yunnan Province, Yunnan Zhaotong, 654600
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Abstract：Objective：To explore the main risk factors influencing adverse treatment outcomes in patients with pulmonary tuberculosis, and to provide a basis for improving treatment effects and prognosis of patients. Methods: A retrospective analysis was conducted on 54 patients with pulmonary tuberculosis admitted to our hospital from October 2023 to October 2024. According to the treatment outcomes, they were divided into the good treatment group（n=32）and the poor outcome group（n=22）. Adverse outcomes include treatment failure, recurrence, treatment discontinuation and disease progression, etc. The demographic characteristics, smoking and drinking history, body mass index（BMI）, disease duration, comorbidities, range of pulmonary lesions, presence or absence of cavity formation, medication compliance and adverse reactions of the patients were collected. Logistic regression model was used to analyze the independent risk factors affecting the treatment outcome. Results: Compared with the well-treated group, patients in the adverse outcome group were more likely to be male, have a history of smoking, have other chronic diseases, have a lower BMI level, have pulmonary cavity formation, have ≥3 lung field lesions, and have poor treatment compliance. Logistic regression analysis showed that smoking history, comorbidities, low BMI, cavity formation and multiple lung field lesions（≥3）were independent risk factors for adverse treatment outcomes（P < 0.05）, while good treatment compliance was a protective factor（P < 0.05）.
Keywords : Tuberculosis Treatment outcome；Influencing factors
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