1.Risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis
Luyi LYU ; Ling YE ; Jianhua LAN ; Min FANG ; Tao WANG ; Zhiyu WU ; Shugen WU ; Weili LU ; Chunxian PENG ; Tao LU
Chinese Journal of Clinical Infectious Diseases 2024;17(6):449-456
Objective:To analyze the risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis(PTB).Methods:Clinical data of 726 patients with rifampicin-sensitive PTB admitted in Quzhou Hospital Affiliated to Wenzhou Medical University from January 2020 to December 2021 were retrospectively analyzed,including 628 cases with favourable treatment outcomes(favourable group)and 98 cases with unfavourable treatment outcomes(unfavourable group). After excluding the lost to follow-up cases and non-tuberculosis-related death cases,there were 659 survival cases(survival group)and 16 cases of tuberculosis-related death(fatal group). Univariate and multivariate Logistic regression were used to analyze the related risk factors.Results:Among 98 cases with unfavourable treatment outcomes,42 cases died from non-tuberculosis causes,32 cases lost follow-up,16 cases died from tuberculosis and 8 cases had failed treatment. Multivariate Logistic regression analysis showed that age≥60( OR=2.515,95% CI 1.461-4.330),retreatment of tuberculosis( OR=2.502,95% CI 1.255-4.989),chronic obstructive pulmonary disease( OR=2.796,95% CI 1.607-4.865),respiratory failure( OR=6.373,95% CI 2.320-17.506),hypoproteinemia( OR=3.149,95% CI 1.876-5.286)and elevated C-reactive protein( OR=1.007,95% CI 1.002-1.012)were independent risk factors for unfavorable treatment outcomes in rifampicin-sensitive PTB patients(all P<0.01);retreated pulmonary tuberculosis( OR=4.542,95% CI 1.182-17.449),complicated respiratory failure( OR=14.186,95% CI 3.038-66.252)and body mass index<18.5 kg/m 2( OR=5.179,95% CI 1.333-20.119)were independent risk factors for poor prognosis in rifampicin-sensitive PTB patients( P<0.05 or <0.01). Conclusion:The older age,low BMI,hypoproteinemia,elevated C-reactive protein,comorbidities and retreatment are risk factors for unfavorable treatment outcomes and poor prognosis in patients with rifampicin-sensitive PTB.
2.Risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis
Luyi LYU ; Ling YE ; Jianhua LAN ; Min FANG ; Tao WANG ; Zhiyu WU ; Shugen WU ; Weili LU ; Chunxian PENG ; Tao LU
Chinese Journal of Clinical Infectious Diseases 2024;17(6):449-456
Objective:To analyze the risk factors of unfavourable treatment outcomes in patients with rifampicin-sensitive pulmonary tuberculosis(PTB).Methods:Clinical data of 726 patients with rifampicin-sensitive PTB admitted in Quzhou Hospital Affiliated to Wenzhou Medical University from January 2020 to December 2021 were retrospectively analyzed,including 628 cases with favourable treatment outcomes(favourable group)and 98 cases with unfavourable treatment outcomes(unfavourable group). After excluding the lost to follow-up cases and non-tuberculosis-related death cases,there were 659 survival cases(survival group)and 16 cases of tuberculosis-related death(fatal group). Univariate and multivariate Logistic regression were used to analyze the related risk factors.Results:Among 98 cases with unfavourable treatment outcomes,42 cases died from non-tuberculosis causes,32 cases lost follow-up,16 cases died from tuberculosis and 8 cases had failed treatment. Multivariate Logistic regression analysis showed that age≥60( OR=2.515,95% CI 1.461-4.330),retreatment of tuberculosis( OR=2.502,95% CI 1.255-4.989),chronic obstructive pulmonary disease( OR=2.796,95% CI 1.607-4.865),respiratory failure( OR=6.373,95% CI 2.320-17.506),hypoproteinemia( OR=3.149,95% CI 1.876-5.286)and elevated C-reactive protein( OR=1.007,95% CI 1.002-1.012)were independent risk factors for unfavorable treatment outcomes in rifampicin-sensitive PTB patients(all P<0.01);retreated pulmonary tuberculosis( OR=4.542,95% CI 1.182-17.449),complicated respiratory failure( OR=14.186,95% CI 3.038-66.252)and body mass index<18.5 kg/m 2( OR=5.179,95% CI 1.333-20.119)were independent risk factors for poor prognosis in rifampicin-sensitive PTB patients( P<0.05 or <0.01). Conclusion:The older age,low BMI,hypoproteinemia,elevated C-reactive protein,comorbidities and retreatment are risk factors for unfavorable treatment outcomes and poor prognosis in patients with rifampicin-sensitive PTB.
3.Effects of cinepazide maleate injection on blood pressure in patients with acute ischemic stroke and hypertension
Huisheng CHEN ; Yi YANG ; Jun NI ; Guofang CHEN ; Yong JI ; Fei YI ; Zhuobo ZHANG ; Jin WU ; Xueli CAI ; Bei SHAO ; Jianfeng WANG ; Yafang LIU ; Deqin GENG ; Xinhui QU ; Xiaohong LI ; Yan WEI ; Shugen HAN ; Runxiu ZHU ; Jianping DING ; Hua LYU ; Yining HUANG ; Yonghua HUANG ; Bo XIAO ; Tao GONG ; Xiaofei YU ; Liying CUI
Chinese Journal of Internal Medicine 2022;61(8):916-920
Objective:To investigate the blood pressure change in patients with acute ischemic stroke (AIS) and hypertension treated with cinepazide maleate injection.Methods:This was a subgroup analysis of post-marketing clinical confirmation study of cinepazide maleate injection for acute ischemic stroke: a randomized, double-blinded, multicenter, placebo-parallel controlled trial, which conducted in China from August 2016 to February 2019. Eligible patients fulfilled the inclusive criteria of acute anterior circulation ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 7-25. The primary endpoints were mean blood pressure of AIS patients treated with cinepazide maleate or control, which were assessed during the treatment period (14 days), and the proportion of the patients with normal blood pressure was analyzed after the treatment period. Furthermore, a subgroup analysis was performed to investigate a possible effect of the history of hypertension on outcomes.Results:This analysis included 809 patients with hypertension. There was no significant difference in patients blood pressure and the proportion of patients with normal blood pressure (60.5% vs. 59.0%, P>0.05) between cinepazide maleate group and control group. Conclusion:Administration of cinepazide maleate injection does not affect the management of clinical blood pressure in patients with AIS.
4.Factors related to false negative results of interferon-γ release test in patients with confirmed pulmonary tuberculosis
Ling YE ; Jianhua LAN ; Min FANG ; Shun WANG ; Zhiyu WU ; Shugen WU ; Chunxian PENG ; Weili LU ; Tao LU
Chinese Journal of Clinical Infectious Diseases 2022;15(6):454-458
Objective:To analyze the influencing factors related to false-negative results of interferon-γ release assay (IGRA) QFT-GIT in patients with confirmed pulmonary tuberculosis.Methods:Clinical data of 389 patients with bacteriologically confirmed pulmonary tuberculosis who underwent QFT-GIT in Quzhou Hospital Affiliated to Wenzhou Medical University between January 1 and December 31 2020 were retrospectively analyzed. Univariate and multivariate logistic regression were used to analyze the influencing factors related to the false-negative results of QFT-GIT.Results:Among 389 confirmed patients, 347 cases had positive QFT-GIT results and 42 cases had negative results. Univariate analysis showed that the false-negative results of QFT-GIT were associated with low BMI, reduced CD4 + T lymphocyte count, decreased lymphocyte count, increased C-reactive protein, negative sputum smear, anemia, diabetes mellitus, malignant tumor and sepsis ( P<0.05 or P<0.01). Multivariate conditional logistic regression analysis showed that BMI <18.5 kg/m 2( OR=1.585, 95% CI 1.076-2.336), complicated with diabetes( OR=5.157, 95% CI 2.340-11.365), malignant tumors ( OR=5.596, 95% CI 2.048-15.295)and sepsis ( OR=4.141, 95% CI 1.042-16.459) were independent risk factors for the false-negative results of QFT-GIT ( P<0.05 or P<0.01). Conclusion:When the pulmonary tuberculosis patients are extreme emaciation, complicated with diabetes, malignant tumor or sepsis, the QFT-GIT results will be false negative.

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