妊娠期结核病的临床表现和治疗结果:一项前瞻性队列研究。

PubMed ID
发表日期 2020年Sep月

原始出处 BMC传染病
BMC infectious diseases
作者 van de Water  Brittney J  Brooks  Meredith B  Huang  Chuan-Chin  Trevisi  Letizia  Lecca  Leonid  Contreras  Carmen  Galea  Jerome  Calderon  Roger  Yataco  Rosa  Murray  Megan  Becerra  Mercedes C 

文献标题 妊娠期结核病的临床表现和治疗结果:一项前瞻性队列研究。
Tuberculosis clinical presentation and treatment outcomes in pregnancy: a prospective cohort study.

文献摘要 BACKGROUND

专门指导孕妇结核病治疗的研究有限,很少有研究描述孕妇结核病的表现。我们的目的是了解在低艾滋病负担环境中孕妇的结核病表现和治疗结果。我们描述了秘鲁利马一组接受结核病治疗的育龄妇女,并比较了2009年至2012年间孕妇和非孕妇(包括36名孕妇)的临床表现和治疗结果。

METHODS

这是一项前瞻性队列研究。受试者来自秘鲁利马106个公共卫生中心。收集基线人口学、病史和药敏试验结果。我们使用描述性统计来描述人口统计学和临床特征的妇女使用皮尔逊卡方检验,费舍尔精确检验,或克鲁斯卡尔瓦利斯。

RESULTS

在4500名肺结核患者中,1334名妇女和36名孕妇(2.69%)被纳入分析。孕妇的人口统计学特征、既往病史和临床表现与非孕妇相似,只是更可能已婚(p = 0.01)和患有心脏病(p = 0.04),体重减轻的可能性更小(p = 0.05)。20名孕妇(71.4%)患有泛敏感结核病,与616名非孕妇(63.1%)相比;4名孕妇(14.3%)患有单药耐药结核病,与154名非孕妇(15.8%)相比;4名孕妇(14.3%)患有多药耐药结核病,与140名非孕妇(14.3%)相比(p = 0.53)。28名(96.6%)孕妇有成功的结果(治愈、完成治疗、临床团队提前结束治疗),1名(3.4%)有不成功的结果(治疗失败),1074名(97.3%)非孕妇有成功的结果,30名(2.7%)有不成功的结果(p = 0.56)。

CONCLUSION

在这一低HIV合并感染的队列中,我们发现无论是孕妇还是非孕妇,结核病治疗成功率都很高。如果治疗得当,患有结核病的孕妇可以取得成功。


BACKGROUND

There is limited research to guide TB treatment specifically in pregnant women and few studies have described the presentation of TB in pregnant women. We aimed to understand TB presentation and treatment outcomes in pregnant women in a low HIV burden setting. We describe a cohort of women of childbearing age treated for TB disease in Lima, Peru, and compare clinical presentation and treatment outcomes among pregnant and non-pregnant women between 2009 and 2012, including 36 pregnant women.

METHODS

This is a prospective cohort study. Subjects were recruited from across 106 public health centers in Lima, Peru. Baseline demographic, medical history, and drug-susceptibility test results were collected. We used descriptive statistics to describe demographic and clinical characteristics of the women using Pearson chi-squared, Fisher's exact tests, or Kruskal-Wallis.

RESULTS

Among 4500 individuals with pulmonary TB disease, 1334 women were included in analysis with 36 (2.69%) pregnant women. Pregnant women had similar demographics, past medical histories, and clinical presentation to non-pregnant women, except being more likely to be married (p = 0.01) and have cardiac disease (p = 0.04) and less likely to have weight loss (p = 0.05). Twenty (71.4%) pregnant women had pan-susceptible TB compared with 616 (63.1%) non-pregnant women; four (14.3%) pregnant women had mono-resistant TB compared with 154 (15.8%) non-pregnant women; and four (14.3%) pregnant women had multi-drug-resistant TB compared with 140 (14.3%) of non-pregnant women (p = 0.53). Twenty-eight (96.6%) pregnant women had a successful outcome (cure, completed treatment, treatment ended early by clinical team) while one (3.4%) had an unsuccessful outcome (treatment failed) and 1074 (97.3%) non-pregnant women had a successful outcome while 30 (2.7%) had an unsuccessful outcome (p = 0.56).

CONCLUSION

In this cohort with low HIV co-infection, we found high TB treatment success rates in both pregnant and non-pregnant women, irrespective of drug-susceptibility profiles. If treated appropriately, pregnant women with TB disease can have successful outcomes.


获取全文 10.1186/s12879-020-05416-6