Abstract: Objective To explore the relevant factors affecting the early curative effect of multidrug-resistant pulmonary tuberculosis, and to provide the basis for the early curative effect evaluation and precise treatment of multidrug-resistant pulmonary tuberculosis. Method Patients with multidrug-resistant pulmonary tuberculosis who were diagnosed by sputum culture and drug sensitivity in the Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine between November 2020 and January 2022 were selected as the research subjects. According to the treatment effect of anti-tuberculosis treatment at the end of 3 months, the patients were divided into: poor curative effect group (n=35) and good curative effect group (n=117). The clinical data of the two groups were compared, to analyze the risk factors of poor early curative effect. Result Univariate variance analysis showed that: gender, age, occupation, retreatment, T2DM, infections with other pathogens, fluoroquinolone resistance, lesions involving lung fields≥3, cavity, cavity diameter, Hb level, albumin, and BMI index were associated with poor efficacy at the end of 3 months (all P<0.05); Logistic regression multivariate analysis Shows: Retreatment of tuberculosis (OR=4.138, 95%CI 1.063-16.110), quinolone resistance (OR=6.677, 95%CI 1.526-29.211), and pulmonary cavitation (OR=18.879, 95%CI 3.585-99.411) were independent risk factors for poor outcomes after 3 months of MDR-TB treatment. Conclusion There are multiple factors affecting the early treatment effect of MDR-TB. Retreatment of pulmonary tuberculosis, combined with pulmonary cavitary lesions and resistance to fluoroquinolone are independent risk factors for poor early treatment effect. Patients with the above risk factors should be detected earlier, and accurate anti-tuberculosis treatment should be performed in order to improve the prognosis.

Key words: Multidrug-resistant pulmonary tuberculosis, Early efficacy, Risk factors, Re-treatment of tuberculosis, Pulmonary cavitary lesions, Fluoroquinolone