摘要
目的了解复治涂阳肺结核病病人的耐药及影响因素,为制定耐药结核病预防控制策略提供依据。方法采取整群抽样方法,选取2015—2017年新疆喀什地区开展耐药监测县(市)报告的复治涂阳肺结核病病人392例,以培养阳性并有药敏实验结果的340例为研究对象,通过问卷调查获得其就诊史和用药史;卡方检验比较耐药率的差异、Logistic回归分析耐药影响因素。结果340例复治涂阳肺结核病病人总耐药率为25.00%,耐多药率5.29%;单因素Logistic回归分析,年龄30岁~组(χ^2=7.71)、女性(χ^2=10.72)、家庭年收入低于5000元(χ^2=12.39)、治疗次数少于3次(χ^2=5.08)及治疗期未停药(χ^2=12.90)的肺结核病病人分离的结核杆菌耐药率与其他对应组的病人相比,差异有统计学意义(均P<0.05);多因素Logistic回归分析,年龄30岁~组(χ^2=9.71,OR=2.49,95%CI=1.40~4.41)、家庭年收入低于5000元(χ^2=8.27,OR=2.18,95%CI=1.28~3.71)、治疗期有停药(χ^2=33.98,OR=3.59,95%CI=1.84~7.00)是复治涂阳肺结核病病人耐药性产生的危险因素。结论340例复治涂阳肺结核病病人耐药情况低于全国和全疆平均水平,年龄、家庭年收入和治疗期间停药是产生耐药性的危险因素。
Objective To understand drug resistance and influencing factors of inpatients with retreated smear positive pulmonary tuberculosis, provide basis for formulating prevention and control strategies of drug resistance tuberculosis. Methods There were 340 patients with smear positive and drug sensitive testing results selected as the subjects among 392 retreated patients with smear positive pulmonary tuberculosis reported in all counties (cities) conducting drug resistance monitoring in Kashi prefecture duing 2015—2017 with cluster sampling method. The history of clinic visit and medication was collected through questionnaire survey. The influencing factors were analyzed by Chi square test and Logistic regression. Results In 340 retreated patients with smear positive pulmonary tuberculosis, the rate of total resistance and multi-drugs resistance was 25.00% and 5.29%, respectively. In univariate Logistic regression, there were statistical differences (all P<0.05) in the resistance rates between patients with Mycobacterium tuberculosis and other patients of 30-60 year-old (χ^2=7.71), women (χ^2= 10.72), with annual income under 5 000 RMB (χ^2=12.39), treatment less than 3 times (χ^2=5.08) and no withdraw during treatment (χ^2=12.90). In multi factors Logistic regression, 30-60 year-old (χ^2=9.71, OR=2.49, 95%CI=1.40-4.41), annual income under 5 000 RMB (χ^2=8.27, OR=2.18, 95%CI=1.28-3.71) and treatment interruption (χ^2=33.98, OR=3.59, 95%CI=1.84-7.00) were the risk factors of drug resistance in retreated cases of smear positive pulmonary tuberculosis. Conclusions The drug resistance level in 340 retreated patients with smear positive pulmonary tuberculosis is lower than the average level of Xinjiang and nation. Age, family annual income and withdrawal during treatment are the risk factors of drug resistance.
作者
刘年强
古丽娜·巴德尔汗
赵珍
阿依努尔·莫合买提
王乐
王希江
LIU Nian-qiang;Gulina BADEERHAN;ZHAO Zhen;Ayinuer MOHEMAITI;WANG Le;WANG Xi-jiang(The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830002, China)
出处
《疾病预防控制通报》
2018年第6期28-30,共3页
Bulletin of Disease Control & Prevention(China)
关键词
肺结核病
耐药性
影响因素
Pulmonary tuberculosis
Drug resistance
Influencing factors
