Influencing factors of poor prognosis in patients with initial smear-positive pulmonary tuberculosis
Objective:To analyze influencing factors of poor prognosis in patients with initial smear-positive pulmonary tuberculosis.Methods:A cross-sectional study was conducted on 203 patients with initial smear-positive pulmonary tuberculosis admitted to Tongxu county center for disease control and prevention from January 2018 to December 2022.All patients were treated with 2HRZE/4HR anti-tuberculosis treatment.The prognosis was evaluated 3 months after treatment.According to the occurrence of poor prognosis,Logistic regression analysis was used to analyze the influencing factors of poor prognosis in the patients with initial smear-positive pulmonary tuberculosis.Results:Among the 203 initial smear-positive pulmonary tuberculosis patients,55 had a poor prognosis,accounting for 27.09％(55/203).They were assigned to the poor prognosis group.148 cases had good prognosis and they were assigned to the good prognosis group.The proportions of the patients with age≥40 years old,body mass index<18.5 kg/m2,educational level of high school or below,combined pulmonary infection,moderate to severe severity of the condition,serum IFN-γ level<10.73 pg/mL,CD3+<53.86％,CD4+<32.71％,CD4+/CD8+<0.93,Interleukin(IL)-15≥42.85 ng/mL,Sequential organ failure assessment(SOFA)score≥2.46 points,Acute Physiology and chronic health Ⅱ(APACHE Ⅱ)score≥7.82 points,High resolution CT(HRCT)score≥42.26 points in the poor prognosis group was higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that body mass index<18.5 kg/m2,serum IFN-γ level<10.73 pg/mL,CD3+<53.86％,CD4+<32.71％,CD4+/CD8+<0.93,IL-15≥42.85 ng/mL,SOFA score≥2.46 points,APACHE Ⅱ score≥7.82 points and HRCT score≥42.26 points were all risk factors for poor prognosis in the patients with initial smear-positive pulmonary tuberculosis(OR>1,P<0.05).Conclusions:Body mass index<18.5 kg/m2,serum IFN-γ level<10.73 pg/mL,CD3+<53.86％,CD4+<32.71％,CD4+/CD8+<0.93,IL-15≥42.85 ng/mL,SOFA score≥2.46 points,APACHE Ⅱ score≥7.82 points and HRCT score≥42.26 points are the risk factors for poor prognosis in the patients with initial smear-positive pulmonary tuberculosis.
万方数据
维普
