| Objective: To explore the related factors affecting the efficacy of multidrugresistant pulmonary tuberculosis(MDR-PTB)in Hainan Province,and provide basis for clinical prevention and treatment.Method: 1.Using computer retrieval and collection of research literature on the influencing factors of MDR-PTB efficacy in Chinese and English databases,with a time range from database establishment to January 2023,meta-analysis was conducted using Revman 5.4 after screening and quality evaluation.2.Take the MDR-PTB inpatients who admitted in the designated hospital for treatment of MDR-PTB in Hainan Province from June 2015 to December 2020 as the research object,and conduct a retrospective case control study under the guidance of the Meta analysis results to analyze the relevant factors affecting the efficacy of MDR-PTB in Hanian province.On this basis,analyze the factors that affect patient treatment adherence.Result: 1.A total of 3349 articles were retrieved for systematic review,and 20 were ultimately included for combined analysis.The total sample size was 7328 cases,and the results showed that complications,retreatment,adverse reactions,and male gender,the OR value and its 95% CI are respectively 4.46(3.43～5.79)、2.63(2.20～3.15)、3.64(2.30～5.78)、2.33(1.78～3.05),were risk factors affecting the efficacy of MDR-PTB.2.From June 2015 to December 2020,299 effective cases were screened among hospitalized pulmonary tuberculosis patients,including 246 males and 53 females,with an average age of 45.55 ± 15.54 years old.The results of multivariate analysis showed that seven factors,including poor treatment adherence,extensively drug resistance,high levels of sputum culture bacteria,bronchiectasis,retreatment,adverse reactions,and males,were risk factors affecting the efficacy of MDR-PTB,the OR value and its 95% CI are 11.52(6.19～21.43)、4.37(1.32～14.49)、3.16(1.70～5.85)、2.69(1.37～5.29)、2.66(0.89～7.88)、2.32(1.28～4.21)、2.32(1.04～5.20)3.Multivariate analysis showed that age ≥ 60 years,high level of sputum culture bacteria,drinking history,irregular treatment during the course of tuberculosis,lung damage,and other complications were the promoting factors for poor treatment adherence,the OR value and its 95% CI are 4.27(2.24～8.18)、2.62(1.53～4.48)、2.24(1.30～3.87)、2.12(1.26～3.59)、1.71(0.96～3.06)、1.55(0.94～2.57).Conclusion:Based on meta-analysis and retrospective research results,the main factors affecting the treatment effectiveness of MDR-PTB in hainan province are treatment compliance,widespread drug resistance,sputum culture count,presence or absence of bronchiectasis,retreatment,adverse reactions,and gender.The highest correlation is patients’ treatment adherence;The main factors influencing treatment adherence are age,bacteria level of sputum culture,drinking history,irregular treatment history of tuberculosis,lung damage and complications. |
