无锡市城区登记肺结核患者一线抗结核药物耐药特征和相关因素分析

发布时间：2018-04-25 02:06

本文选题：结核 + 肺　；参考：《现代预防医学》2015年03期

【摘要】：目的分析2011-2012年无锡市城区登记的肺结核患者的耐药情况和相关因素。方法 2011-2012年无锡市城区结核病防治机构登记的所有初治和复治肺结核患者,对痰结核菌培养阳性的标本进行一线抗结核药物(异烟肼,利福平,链霉素,乙胺丁醇)体外敏感试验,分析耐药结果。将患者性别、既往化疗史、糖尿病与肺结核耐药发生的关系用非条件Logistic多因素回归分析。将患者的年龄分布与肺结核耐药发生的关系用非条件Logistic单因素分析。结果2011-2012年无锡市城区共登记痰培养阳性的肺结核患者总耐药率14.9%,耐多药率4.7%,原发性耐药率11.5%,原发性耐多药率2.5%,获得性耐药率26.8%,获得性耐多药率13.4%。对一线抗结核药物的耐药顺位依次是:利福平,链霉素,异烟肼,乙胺丁醇。既往结核病治疗史患者发生耐药的危险约是无结核病治疗史患者的3.5倍,70岁以上的老年患者比低年龄患者更易产生耐药(OR=1.191)。结论本地区耐药结核病的流行处于国内较低水平。但是耐多药率,尤其是获得性耐多药率仍处于较高水平,利福平耐药是本地区一线抗结核药物耐药首位,既往结核病治疗史是产生结核病耐药的高危因素,老年结核病的防治重点是增加患者治疗的依从性,减少结核病耐药的发生
[Abstract]:Objective to analyze the drug resistance and related factors of pulmonary tuberculosis patients registered in Wuxi city from 2011 to 2012. Methods from 2011 to 2012, all newly treated and retreated tuberculosis patients registered by tuberculosis control institutions in Wuxi city were treated with first-line anti-tuberculosis drugs (isoniazid, rifampicin, streptomycin). Ethambutanol) sensitivity test in vitro to analyze the results of drug resistance. The relationship between sex, previous chemotherapy history, diabetes mellitus and pulmonary tuberculosis resistance was analyzed by non-conditional Logistic multivariate regression analysis. The relationship between age distribution and drug resistance in pulmonary tuberculosis was analyzed by non-conditional Logistic single-factor analysis. Results the total drug resistance rate, multidrug resistance rate, primary drug resistance rate, primary multidrug resistance rate, acquired drug resistance rate and acquired multidrug resistance rate were 14.9, 4.7, 11.5, 2.5, 26.8 and 13.4, respectively. The sequence of resistance to first-line anti-tuberculosis drugs is rifampicin, streptomycin, isoniazid, ethambutanol. The risk of drug resistance in patients with previous history of tuberculosis treatment was about 3.5 times higher than that in patients aged 70 years or older without tuberculosis treatment history, and the risk of drug resistance in patients over 70 years old was higher than that in patients with low age. Conclusion the prevalence of drug-resistant tuberculosis in this area is at a low level in China. However, the rate of multidrug resistance, especially acquired multidrug resistance, is still at a high level, rifampicin resistance is the first in the first line of anti-tuberculosis drug resistance in the region, and the history of previous tuberculosis treatment is a high risk factor for the development of tuberculosis drug resistance. The focus of the prevention and treatment of senile tuberculosis is to increase the compliance of patients and reduce the incidence of drug resistance of tuberculosis.
【作者单位】：无锡市第五人民医院;
【分类号】：R521

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