对一线抗结核药物的不良反应的决定因素:一个前性队列研究
Richard Delali Agbeko Djochie1, Berko Panyin Anto2, Mercy Naa Aduele Opare-Addo1
1Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences Kwame Nkrumah University of Science and Technology, Kumasi Private Mailbag, Kumasi, Ghana.
近一半的结核病患者经历了不良药物反应,影响了治疗的坚持. 风险因素包括年龄,性别,酒精使用,艾滋病毒和肺外结核病.
科学领域:
- 药物监测和传染病管理
- 抗结核药物的临床药理学
- 患者的坚持和治疗结果.
背景情况:
- 结核病 (TB) 治疗的成功取决于患者遵守药物治疗方案.
- 对抗结核病药物的不良药物反应 (ADR) 显著降低了结核病的坚持,并导致治疗结果不佳.
- 了解ADR对于个性化和有效的结核病管理至关重要.
研究的目的:
- 调查一线抗结核药物副作用的类型,发病率和严重程度.
- 确定与这些ADRs发展相关的社会人口和临床因素.
- 为改善患者坚持治疗和结核病治疗成功的策略提供信息.
主要方法:
- 在整个治疗过程中对新诊断的活跃结核病患者进行前性监测.
- 系统地记录所有遇到的抗结核药物不良反应.
- 统计分析包括ANOVA,Chi-squared,费舍尔的精确,独立的t测试,以及物流回归来识别风险因素.
主要成果:
- 在378名患者中,有181人 (47.9%) 经历了至少一个ADR,每100人月发生事件的发生率为1.75.
- 胃肠道,神经系统和皮肤是受影响最严重的系统,主要是在密集治疗阶段.
- 副作用的危险因素包括45岁以上的年龄,肺外结核病,女性性别,酒精使用和艾滋病毒感染.
结论:
- 饮酒,吸烟,艾滋病毒阳性,女性性别和肺外结核病是ADRs的重要危险因素.
- 识别这些风险因素使得有针对性的干预措施能够减轻副作用并改善结核病治疗的坚持.
- 基于已识别的风险因素的个性化治疗方法可以提高结核病治疗患者的结果.
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