Objective: To explore the effect of alcohol drinking on sputum culture conversion at the end of second month and outcome of smear-positive pulmonary tuberculosis (PTB) patients. Methods: Total 2 067 patients aged 18 years and above diagnosed and treated from 2008 to 2011 in 49 TB institutions from 8 provinces, antonomous regions and municipalities were enrolled, according to tuberculosis situation and regional distribution in China. Those patients were divided into three groups according to alcohol drinking, including never alcohol drinker group, ever-alcohol drinker group and current alcohol drinker group, respectively. Chi-square test was used to compare the following variables among the three groups: adverse action, lesions absorption, cavity size, sputum-culture results at the end of the 2(nd) month of treatment, and treatment outcome. Multivariate Logistic regression was used to explore that whether alcohol drinking was risk factor of poor treatment effect. Results: Among the 2 067 smear-positive PTB patients, never drinkers, ex-drinkers and current drinkers account for 55.2% (1 140/2 067), 36.5% (755/2 067), 8.3% (172/2 067), respectively. Among patients of never drinkers, ex-drinkers and current drinkers groups, sputum-culture conversion rate at the end of the 2(nd) month of treatment were 86.1%, 81.3% and 83.0%, respectively (χ(2)=6.782, P=0.033); the difference in treatment outcome was significant (χ(2)=13.620, P=0.034). Treatment success rate were 83.9%, 81.1% and 79.7%, respectively; failure rate was 6.4%, 10.3% and 9.9%, respectively, and fatality rate were 2.1%, 2.3% and 4.1%, respectively. Multivariate Logistic regression analysis showed that non-sputum conversion of the end of 2(nd) month and fatality rate of ex-drinkers were 1.431 and 1.668 times higher than never drinkers, respectively; non-sputum conversion of the end of 2(nd) month of current drinkers was 1.256 times higher than never drinkers. Conclusion: Alcohol drinking affects the treatment effectiveness of tuberculosis, which increased risk of culture-positive rate of the end of 2(nd) month and fatality rate.
目的： 探讨饮酒对涂阳肺结核患者治疗2个月末痰菌阴转及治疗转归的的影响。 方法： 根据我国结核病疫情及地域分布情况，2008—2011年选择我国8个省自治区、直辖市共49个实施单位确诊的年龄≥18岁的2 067例涂阳肺结核患者基本情况及治疗效果进行分析，根据患者饮酒情况分为不饮酒、戒酒及现在饮酒3组，比较不饮酒、戒酒及现在饮酒3组患者在不良反应、病灶吸收、空洞闭合、2个月末痰培养及治疗转归方面的差异，分析饮酒对肺结核疗效的影响。 结果： 在2 067例涂阳肺结核患者中，不饮酒组占55.2%（1 140/2 067），戒酒组占36.5%（755/2 067），现在饮酒组占8.3%（172/2 067）；不饮酒、戒酒及现在饮酒3组患者2个月末痰菌阴转率分别为86.1%、81.3%及83.0%（χ(2)=6.782，P=0.033）；治疗转归差异有统计学意义（χ(2)=13.620，P=0.034），治疗成功率分别为83.9%、81.1%及79.7%，治疗失败率分别为6.4%、10.3%及9.9%，病死率分别为2.1%、2.3%及4.1%。多因素Logistic回归分析结果显示，戒酒组患者2个月末痰培养未阴转率及病死率分别是不饮酒组患者的1.431及1.668倍，现在饮酒组患者2个月末痰培养未阴转率是不饮酒组患者的1.256倍。 结论： 饮酒可影响肺结核疗效，增加患者2个月末痰菌未阴转率及死亡的风险。.
Keywords: Alcohol drinking; Bacterial culture; Treatment outcome; Tuberculosis, pulmonary.