Analysis Of Clinical Correlation Factors In Patients With PTB/AIDS Adjusted Hrze Anti-Tuberculosis Regimen

Objective:To investigate the independent influencing factors of adjusting HRZE anti-tuberculosis regimen in inpatients with PTB/AIDS.Methods:Clinical data of 100 patients with PTB/AIDS who were hospitalized in Yulin City Red Cross Hospital from January 2019 to June 2022 were retrospectively collected.This includes sex,age,CD4~+T lymphocyte count,white blood cell count,total bilirubin,albumin,body mass index,etiology,adverse drug reactions,whether to combine with antifungal drugs,whether to combine with sulfonamides,whether to take highly effective antiretroviral therapy,etc.According to whether the HRZE anti-tuberculosis regimen was adjusted during hospitalization,59 cases were divided into the adjusted anti-tuberculosis regimen group and41 cases were not adjusted.The clinical data of the two groups were analyzed by univariate analysis,and then the influencing factors of the adjusted anti-tuberculosis regimen were analyzed by multivariate logistic regression.Results:(1)Among the study subjects,there were 61 patients with adverse drug reactions,and the incidence of adverse drug reactions was 61.0%(61/100),mainly manifested as digestive tract reaction,liver function impairment,bone marrow suppression,skin allergic reaction,and hyperuricemia,among which 13 patients had two adverse drug reactions,and 2patients had three adverse drug reactions at the same time.The classification of adverse drug reactions in patients with digestive tract reactions was mainly at grade 2-3,accounting for88.46%;adverse drug reactions in patients with liver impairment were mainly grade 2-3,accounting for 68.18%;adverse drug reactions in patients with hyperuricemia were mainly grade 1-2,accounting for 71.43%;and patients with bone marrow suppression were mainly at grade 2,accounting for 75.00%;and patients with skin allergic reactions were mainly grade 2-3,accounting for 85.72%.(2)Age,sex,body mass index,nutritional risk screening,tuberculosis type,combined antifungal,combined antiviral,combined sulfonamide therapy,whether or not combined hepatitis,baseline white blood cell count,baseline platelet count,baseline hemoglobin,erythrocyte sedimentation rate,procalcitonin,C-reactive protein,erythrocyte sedimentation rate,baseline albumin,baseline total bilirubin,baseline alanine aminotransferase,CD4~+T lymphocytes Counting was not a factor influencing the adjustment of antituberculosis treatment in patients with PTB/AIDS co-infection(P>0.05).(3)Multivariate logistic regression analysis showed that with the combined antifungal treatment,the baseline direct bilirubin level was PTB/AIDS Factors influencing the development of adjusted anti-TB regimen in double infected patients(P=0.023,OR(95%CI)=3.074(1.168-8.089);P=0.010,OR(95%CI)=1.244(1.053-1.471))。Conclusion:The independent factors influencing the adjustment of PTB/AIDS inpatients were baseline direct bilirubin levels and combined antifungal therapy.In clinical work,when the baseline direct bilirubin high and(or)combined with antifungal therapy is found in PTB/AIDS inpatients,attention should be paid to adjust the anti-tuberculosis treatment regimen to make the patients complete the anti-tuberculosis treatment more safely and effectively.