复治涂阳肺结核患者耐药危险因素探讨

发布时间：2018-09-18 20:51

【摘要】：目的探索广西复治涂阳肺结核患者耐药产生的危险因素。方法利用2010-2011年广西结核病耐药性监测数据,统计359例复治涂阳肺结核患者的社会和既往临床诊疗信息、患者痰标本对异烟肼、利福平、乙胺丁醇、链霉素、卡那霉素及氧氟沙星等6种药物的敏感性试验结果,通过logisitic回归法分析患者耐药相关的危险因素。结果多因素逐步回归分析结果显示,女性(OR=1.988)、少数民族(OR=1.538)、接受过2次以上抗结核治疗(OR=4.352)及不联合用药(OR=2.257)等因素可能会导致患者耐药风险增加。40~59岁年龄组(OR=2.855)、低收入家庭(OR=10.846)、接受过2次以上抗结核治疗(OR=5.570)、登记为复发(OR=5.570)或初治失败(OR=14.935)等因素可能是耐多药产生的危险因素。结论女性、40~59岁、少数民族、低收入家庭、多次治疗及不联合用药等因素可能是广西复治患者耐药或耐多药的主要危险因素。
[Abstract]:Objective to explore the risk factors of drug resistance in retreated smear positive pulmonary tuberculosis patients in Guangxi. Methods based on the data of drug-resistance surveillance of tuberculosis in Guangxi from 2010 to 2011, the social and clinical data of 359 patients with re-treated smear positive pulmonary tuberculosis were analyzed. The sputum samples were collected from patients with isoniazid, rifampicin, ethambutanol, streptomycin. The sensitivity test results of kanamycin and ofloxacin were used to analyze the risk factors related to drug resistance by logisitic regression. Results multiple stepwise regression analysis showed that, Women (OR=1.988), ethnic minorities (OR=1.538), who have received more than two antituberculous therapy (OR=4.352) and non-combination therapy (OR=2.257) may lead to an increased risk of drug resistance. The age group (OR=2.855), low-income families (OR=10.846), more than 2 times of anti-tuberculosis therapy (OR=5.570), Deng. Factors such as recurrence (OR=5.570) or failure of initial treatment (OR=14.935) may be risk factors for multidrug resistance. Conclusion the main risk factors of drug resistance or multidrug resistance in patients with recurrent treatment in Guangxi are female 4059 years old, minority nationality, low income family, multiple treatment and no combination therapy.
【作者单位】：广西壮族自治区疾病预防控制中心结核病防制所;广西医科大学公共卫生学院职业卫生与环境卫生学教研室;
【基金】：广西壮族自治区科技攻关项目(桂科攻1140003A-36)
【分类号】：R521

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