肺结核治疗后复发的时间
1Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
IJTLD open
|October 14, 2024
概括
肺结核 (PTB) 可以通过复发或再感染复发. 复发通常比再感染更早,特别是在结核病负担较低的地区. 了解复发模式有助于PTB管理.
科学领域:
- * 传染病 传染病
- * * 公共卫生 公共卫生
- * 流行病学 流行病学
背景情况:
- * 肺结核 (PTB) 复发在初始治疗后是一个重大挑战.
- *复发可能源于复发 (初始感染的重新激活) 或再感染 (新的感染).
- *区分复发和再感染对于有效的治疗和控制策略至关重要.
研究的目的:
- *系统地审查和分析PTB复发的发生率,时间和原因.
- * 为了比较复发和再感染的时间框架.
- * 调查结核病负担和艾滋病毒状况对复发模式的影响.
主要方法:
- * 在Embase,PubMed,Web of Science和Medline的系统文献搜索中,寻找微生物学记录的PTB复发.
- *分析了23篇文章,报告了75,224名接受治疗的个体中的2,153例PTB复发.
- *使用卡普兰-梅尔曲线来比较时间到复发,复发和再感染;对402例病例使用基因型鉴定.
主要成果:
- * 累计PTB复发率在5年内为2.9%,中位复发时间为18个月.
- *复发发生的时间明显较早 (12个月),而不是再感染 (24个月) (P < 0.001).
- *在低结核病负担的环境中,复发占主导地位 (85%);在高负担的环境中,复发率为56%. 9.5%的复发病例显示药物耐药性.
结论:
- *早期的PTB复发主要是复发,而晚期的复发更经常是再感染.
- * 根据结核病负担和艾滋病毒状况,复发模式不同.
- * 调查结果突出了针对性战略的需要,以应对PTB管理中的复发和再感染.
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