华南预防医学 ›› 2021, Vol. 47 ›› Issue (1): 1-5.doi: 10.12183/j.scjpm.2021.0001

• 论著 •    下一篇

1 201例肺结核患者耐药情况及影响因素分析

雷倩, 王皓, 吕小会, 党丽云, 周俊   

  1. 西安市胸科医院,陕西 西安 710061
  • 收稿日期:2020-02-09 出版日期:2021-01-20 发布日期:2021-02-07
  • 通讯作者: 吕小会,E-mail:lxh65@126.com
  • 作者简介:雷倩(1989—),女,硕士研究生,主管药师,研究方向为临床药学
  • 基金资助:
    陕西省自然科学基础研究项目(2017JQ8016)

Drug resistance and its influencing factors of 1201 patients with pulmonary tuberculosis

LEI Qian, WANG Hao, LV Xiao-hui, DANG Li-yun, ZHOU Jun   

  1. Xi'an Chest Hospital, Xi'an 710061, China
  • Received:2020-02-09 Online:2021-01-20 Published:2021-02-07

摘要: 目的 分析结核病患者的耐药情况及危险因素,为耐药结核病的预防及控制提供依据。方法 收集肺结核治疗定点医院1 201例住院结核病患者相关资料及其结核分枝杆菌药敏资料,采用描述流行病学分析方法进行分析,并采用单、多因素分析方法对结核分枝杆菌耐药影响因素进行分析。结果 1 201例肺结核患者中男性829例(69.03%),女性372例(30.97%)。年龄6~88岁,平均(40.2 ± 18.7)岁。初治患者1 065例(88.68%),复治患者136例(11.32%)。初治患者总耐药率(27.89%)低于复治患者总耐药率(62.50%),差异有统计学意义(P<0.01)。初治患者和复治患者任何药物的耐药率、耐多药率和广泛耐药率均差异有统计学意义(P<0.05或P<0.01)。初治患者的耐药危险因素为抗结核治疗史(OR=1.777)和合并糖尿病(OR=1.568)。复治患者的耐药危险因素是治疗≥2次(OR=3.428)、居住在村镇(OR=3.053)和年龄41~60岁(OR=2.866)。结论 该地区肺结核患者耐药率较高,复治患者耐药率高于初治患者,初治患者和复治患者耐药影响因素不同,应针对不同患者类型采取相应治疗及控制措施,避免患者产生耐药。

关键词: 肺结核, 结核分枝杆菌, 耐药, 影响因素

Abstract: Objective To analyze the drug resistance and its risk factors of pulmonary tuberculosis patients, so as to provide basis for the prevention and control of drug resistant tuberculosis. Methods Data of 1 201 hospitalized tuberculosis patients in designated hospitals and drug sensitivity of M.tuberculosis were collected. Descriptive epidemiological analysis was used to analyze the data, and univariate and multivariate Logistic regressions were used to analyze the factors influencing drug resistance of M.tuberculosis. ResultsThe average age of 1 201 patients with pulmonary tuberculosis was (40.2 ±18.7) years (range, 6-88 years). Among them, 829 (69.03%) were male and 372 (30.97%) were female; 1 065 (88.68%) were newly treated and 136 (11.32%) were retreated. The total drug resistance rate of newly treated patients (27.89%) was lower than that of retreated patients (62.50%) (P < 0.01). The drug resistance rate of any drug, multi drug resistance rate and extensive drug resistance rate were significantly different between newly treated and retreated patients (P < 0.05 or P < 0.01). The risk factors of drug resistance in newly treated patients were anti tuberculosis treatment history (OR=1.777) and diabetes mellitus (OR=1.568), and in retreated patients were treatment ≥ 2 times (OR=3.428), living in villages and towns (OR=3.053) and age of 41-60 years (OR=2.866). ConclusionThe drug resistance rate of pulmonary tuberculosis patients in this area is higher, and the drug resistance rate of retreated patients is higher than that of newly treated patients. The influencing factors of drug resistance of newly treated patients and retreated patients are different. Corresponding treatment and control measures should be taken according to different types of patients to avoid drug resistance.

Key words: Pulmonary tuberculosis, Mycobacterium tuberculosis, Drug resistance, Influencing factor

中图分类号: 

  • R521