Study On The Occurrence And Influencing Factors Of Anti-tuberculosis Drug Adverse Reaction In Hexi Region Of Gansu Province

Objectives The paper study the occurrence and the related factors of anti-tuberculosis drug adverse reaction on the patients with pulmonary tuberculosis to understand the incidence rate,type constitution and related factors of anti-tuberculosis drug adverse reaction in Hexi Region of Gansu Province.Evaluation the anti-tuberculosis drug adverse reaction impact the tuberculosis treatment effect in Hexi region of Gansu province.The research offering help for formulate and consummate the policy of prevention and control of tuberculosis.Methods We used Nested Case-Control method in this research.According to the inclusion criteria,we selected 1415 cases of pulmonary tuberculosis patients as the research object,who received 6 months Directly-Observed Treatment Strategy from January 2015 to May 2016 in The Centre for Disease Control and tuberculosis designated hospitals of LiangZhou District,Minqin county,Gulang county,Tianzhu county,Ganzhou District,Shandan county,Gaotai county,Linze county,Minle county and Sunan county in Wuwei and Zhangye region of Gansu province.After signed the informed consent,we carried out the information query,questionnaires and the 5 tests of hepatitis B for the research object.They received the liver,kidney,blood and urine routine test at the end of 0,1,2,6 months after starting treatment,and we recorded the occurrence of anti-tuberculosis drug adverse reaction.After sorting and statistics the information,include medical records,medication list,laboratory test reports and anti-tuberculosis drug adverse reaction,we analyzed the incidence rate and related factors of anti-tuberculosis drug adverse reaction on the patients with pulmonary tuberculosis.The research object was divided into drug adverse reaction group and normal group,we analyzed the related factors of drug adverse reaction by the single factor and multiple factors logistic regression.Results This study incorporated 1398 valid research objects,and 641 cases happened drug adverse reaction,so the incidence rate of drug adverse reaction was 45.9%.The relevancy degree between the incidence rate of drug adverse reaction and the use of anti-tuberculosis drug for sure,probably,and possible are 0.8%,0.8% and 19.2% respectively.Drug adverse reaction rate of mild,moderate and severe are 76.3%,19.8% and 3.9% respectively,and motor system injury rate,liverinjury rate,blood system injury rate,kidney injury rate,gastrointestinal adverse reaction rate,nervous system injury rate and hypersensitivity rate are 43.7%,23.2%,10.1%,5.8%,7.9%,3.0%,6.3% respectively.In 0-30 days,31-60 days,61-90 days,91-120 days,121-150 days,151-180 days and after 180 days of anti-tuberculosis treatment,the drug adverse reaction rate are 52.9%,18.9%,9.9%,7.1%,4.9%,3.9% and 2.4% respectively.The single factor analysis result of drug adverse reaction in the process of anti-tuberculosis treatment show that there are significance(P≤0.05)between drug adverse reaction group and normal group in age,nationality,result of diagnosis,hepatitis history,drug allergy history and History of BCG vaccination.While the multiple factors logistic regression analysis result show that age,nationality,hepatitis history,drug allergy history and History of BCG vaccination are connect with drug adverse reaction.Compared with the patients younger than 19 years old,the OR and 95%CI of the 20-39,40-59 and older than 60 years patients who occurred drug adverse reaction are 1.208(0.958~1.497)、1.359(1.015~1.748)and 3.268(1.957~9.348)respectively.Compared with the Han nationality,the OR and 95%CI of the Zang nationality,the Hui nationality and ethnic minorities which occurred drug adverse reaction are 0.419(0.297~0.654),0.399(0.315~0.716)and 1.068(0.836~1.129)respectively.For the disease history of pulmonary tuberculosis patients,the OR and 95%CI of liver disease,drug allergy history and history of BCG vaccination are 2.641(1.305~5.031),1.789(1.109~3.004)and 2.014(1.632~2.847)respectively.Conclusions The drug adverse reaction incidence rate in the process of anti-tuberculosis treatment is 45.9% in this study,and it is relevant to age,nationality,result of diagnosis,hepatitis history,drug allergy history and History of BCG vaccination.Multiple factors logistic regression analysis showed that,Compared with the young than 19 years old patients,the old than 60 years old patients have a higher risk;Compared with Han nationality,Zang and Hui nationality are at lower risk;The patients with liver disease history,drug allergy history and History of BCG vaccination are at higher risk for the occurrence of drug adverse reaction.