摘要
目的了解东莞市结核分枝杆菌耐药情况及对耐药肺结核患者影响因素分析,为制定科学的耐药结核病防控策略提供依据。方法采用整群抽样的方法对东莞市2018年经菌种鉴定为结核分枝杆菌感染的1165例患者作为研究对象,将其分为非耐药组、单耐药组和其他耐药组,并通过面对面问卷调查获得患者基本信息、疾病史、治疗史以及患者的登记分类等相关影响因素。单因素分析采用卡方检验、方差分析;多因素分析采用多分类Logistic回归分析。结果1165例结核分支杆菌感染的患者中,平均年龄为39.81±14.56岁,新患者占91.85%,复治患者占8.15%。男性占69.96%,女性占30.04%;本地患者占13.05%,非本地患者占86.95%。总耐药率为12.27%,其中单耐药率为9.79%(114/1165),多耐药率0.25%(3/1165),耐多药率2.23%(26/1165)。单因素分析后,按照P<0.5的水准,性别(χ^2=6.27,P=0.01)、居住地(χ^2=5.49,P=0.06)、职业(χ^2=34.18,P=0.02)、糖尿病史(χ^2=2.78,P=0.25)、结核病史(χ^2=78.03,P<0.001)、治疗时间(χ^2=5.07,P=0.24)、是否停药(χ^2=3.38,P=0.19)和登记分类(χ^2=65.84,P<0.001)、年龄(F=5.13,P=0.01)纳入多因素分析。多分类Logistic回归分析结果显示,低收入(5万元以下P=0.009,OR=18.826,95%CI:2.111-167.901;10万元以下P=0.028,OR=11.692,95%CI:1.307-104.623)、有结核病史(P=0.001,OR=2.553,95%CI:1.458-4.459)、复治患者(P<0.001,OR=0.356,95%CI:0.203-0.626)是单耐药患者的危险因素。高年龄(30岁以下P=0.007,OR=0.190,95%CI:0.057-0.633;50岁以下P=0.011,OR=0.115,95%CI:0.22-0.604)、有结核病史(P<0.001,OR=14.571,95%CI:6.762-31.399)、复治患者(P<0.001,OR=0.082,95%CI:0.038-0.178)是其他耐药发生的危险因素。结论我市总耐药率、单耐药率和其他耐药率低于全国平均水平,高年龄、复治患者和有结核病史是耐药发生的危险因素。
Objective To understand the situation of drug resistance of mycobacterium tuberculosis(MTB)in Dongguan city and analyze the influencing factors of MTB patients.Methods 1165 patients identified as mycobacterium tuberculosis infection in Dongguan in 2018 were studied,and they were divided into non-drug-resistant group,singledrug-resistant group and other drug-resistant group.The basic information,disease history,treatment history,patient registration and classification and other related influencing factors were obtained through questionnaire survey.Chisquare test and variance analysis were used in univariate analysis.Multivariate Logistic regression was used for multivariate analysis.Results Among the 1165 patients with mycobacterium tuberculosis infection,the average age was 39.81±14.56 years old,new patients accounted for 91.85%,and retreated patients accounted for 8.15%.Male accounted for69.96%,female accounted for 30.04%;Local patients accounted for 13.05%and non-local patients accounted for 86.95%.The total drug resistance rate was 12.27%,of which the single drug resistance rate was 9.79%(114/1165).Multidrug resistance rate was 0.25%(3/1165)and multidrug resistance rate was 2.23%(26/1165).After single-factor analysis,gender(χ^2=6.27,P=0.01),residence(χ^2=5.49,P=0.06),occupation(χ^2=34.18,P=0.02),history of diabetes(χ^2=2.78,P=0.25),history of tuberculosis(χ^2=78.03,P=0.001)multivariate analysis was included.The results of multivariate Logistic regression analysis showed that low income(under 50,000 yuan,P=0.009,OR=18.826,95%CI:2.111-167.901);Patients with a history of tuberculosis(P=0.001,OR=2.553,95%CI:1.458-4.459),and patients who were retreated(P<0.001,OR=0.356,95%CI:0.203-0.626)were risk factors for patients with single drug resistance.High age(under the age of 30,P=0.007,OR=0.190,95%CI:0.057-0.633;under the age of 50,P=0.011,OR=0.115,95%CI:0.22-0.604),patients with a history of tuberculosis(P<0.001,OR=14.571,95%CI:6.762-31.399),and patients who were retreated(P<0.001,OR=0.082,95%CI:0.038-0.178)were
作者
闫莉
关福源
钟明浩
罗兰娇
梅月志
YAN Li;GUAN Fu-yuan;ZHONG Minghao(The Sixth People’s Hospital of Dongguan,Dongguan511700,China)
出处
《中国实验诊断学》
2020年第4期539-542,共4页
Chinese Journal of Laboratory Diagnosis
基金
国家疾病预防控制中心资助课题(2018ZX10103001)。
关键词
结核
分枝杆菌
微生物敏感性试验
耐药肺结核
影响因素
Tuberculosis(TB)
Mycobacterium
Microbial sensitivity test
Drug-resistant tuberculosis
Influencing factors
