【摘要】 目的利用Cox比例风险模型探讨直接督导短程化疗(DOTS)策略下初治肺结核患者中断取药治疗(简称中断治疗)的影响因素。方法以山东省滕州市2013—2014年管理治疗的357例初治肺结核患者为研究对象,使用Epi Data 3.1软件建立数据库,用SPSS 19.0软件对初治肺结核患者中断治疗分别进行Kaplan-Meier和Cox比例风险模型的单因素和多因素分析。结果初治肺结核患者中断治疗率为29.7%(106/357),平均治疗中位数时间为58.63 d,Log-rank单因素检验显示,分析的29个因素中,有性别、年龄、文化水平、生活满意度、工作性质、健康状况自评、药物不良反应、规律服药、经济状况、治疗期间外出打工及医疗支出费用11个因素有统计学意义(P<0.05);Cox回归模型多因素分析,有药物不良反应、治疗期间外出打工、服药不规律、经济状况差和生活满意度低5个因素是影响初治肺结核患者中断治疗的危险因素,OR分别为:2.798、2.534、2.508、2.000和1.690。结论 Cox模型应用于肺结核患者中断治疗的研究在国内尚属首次,经实证分析具有较高的使用价值和借鉴意义。更多还原

【Abstract】 [Objective]To explore the influencing factors of interrupted drug therapy among tuberculosis patients accepted initial treatment under DOTS strategy by COX proportional hazard model. [Methods]357 tuberculosis patients accepted initial treatment from 2013-2014 in Tengzhou of Shandong were selected as research objects. The database were established by Epi Data 3.1,and univariate and multivariate analysis of Kaplan-Meier and Cox proportional hazard model for interrupted therapy among tuberculosis patients accepted initial treatment were carried out by SPSS 19.0. [Results]The rate of interrupted therapy among tuberculosis patients accepted initial treatment was 29.7%(106/357),the median of treatment time was 58.63 d. The log-rank univariate analysis showed that among 29 factors,the gender,age,educational level,life satisfaction,job category,selfevaluation of health status,adverse drug reactions,regular drug taking,economic condition,migrant work during therapy and medical cost had statistical significance(P <0.05). They are.The multivariate analysis of Cox model showed that adverse drug reactions,migrant work during therapy,irregular drug taking,poor economic condition and low life satisfaction were the risk factors affected the interrupted therapy of tuberculosis patients accepted initial treatment,OR were 2.798,2.534,2.508,2.000 and 1.690 respectively.[Conclusion]It is the first time to use the Cox model to study interrupted therapy of tuberculosis patients in China. It has a high significance to use and reference.更多还原