吸烟对耐药结核病治疗结果的影响和探索潜在途径:多国队列研究
Matthew L Romo1, Allison LaHood2, Helen R Stagg3
1Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
medRxiv : the preprint server for health sciences
|September 2, 2025
概括
吸烟与多药耐药结核病 (MDR/RR-TB) 治疗结果较差有关. 应对随访损失的干预措施可能会减少这种差异,强调患者在护理中保持成功治疗结核病的重要性.
科学领域:
- 公共卫生
- 传染性疾病
- 临床医学
背景情况:
- 吸烟增加了结核病治疗不良结果的风险.
- 吸烟与结核病治疗成功率降低的具体机制尚不清楚.
- 多药耐药和耐利结核病 (MDR/RR-TB) 存在独特的治疗挑战.
研究的目的:
- 估计吸烟对MDR/RR-TB成功治疗结果的影响.
- 调查吸烟对结核病治疗成功的负面影响是否可以通过对失踪后续治疗进行干预.
- 探索吸烟与结核病治疗结果之间的关联,例如在护理中留守.
主要方法:
- 在使用较新的治疗方案治疗的MDR/ RR- TB患者中进行前性队列研究 (endTB观察研究).
- 用于评估吸烟对治疗成功 (治愈/完成) 的影响的边际标准化.
- 用于模拟对随访损失的干预的反向审查权重的概率.
主要成果:
- 在1786名参与者中,有30.2%是吸烟者.
- 在治疗结束时,吸烟者的治疗成功率较低 (73. 5%),而非吸烟者的成功率 (80. 3%).
- 模拟对失踪后随访的干预减少了观察到的风险差异,这表明留在护理中的时间是关键因素.
结论:
- 吸烟者不经常获得MDR/RR-TB治疗的成功结果.
- 吸烟者与非吸烟者之间治疗成功率的差异很大.
- 改善患者留在护理中的情况可能是改善结核病治疗结果的关键策略.
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