湖南湘潭县农村居民耐多药结核病危险因素病例对照研究

目的探讨湘潭县农村居民耐多药结核病患病的危险因素,为农村耐多药结核病防治提供依据。方法采用1∶1配对病例对照研究方法,在湘潭县"结核病信息管理系统"中抽取耐多药结核病与非耐多药结核病(泛耐药患者除外)的农村居民患者各76名进行入户问卷调查,采用条件logistic回归分析耐多药结核病患病的危险因素。结果单因素分析显示,患者家庭总收入低、低体重(BMI18.5)、文化水平低、结核病接触史、既往不规则结核病治疗史、复治等方面的差异有统计学意义(P0.05);多因素条件logistic回归分析显示,家庭总收入低、结核病接触史、既往不规则结核病治疗史是结核病患者产生耐多药的主要危险因素OR及95%CI分别为1.667(1.105~2.391)、3.471(2.230~5.314)、4.836(3.119~7.538)。结论需采取针对性的措施提高结核病患者治疗依从性,并对家庭困难的结核病患者提供更多的政策支持。

A case-control study on risk factors of rural patients with multi-drug resistant tuberculosis in Xiangtan,Hunan

Objective To investigate the risk factors of rural patients with multi-drug resistant tuberculosis (MDR-TB) in Xiangtan County,so as to provide the evidence for MDR-TB control and prevention.Methods A 1:1 matched casecontrol study was conducted,in which there were 76 MDR-TB patients in a case group and 76 TB patients other than MDR-TB in a control group.All of the TB patients came from "TB Management Information System".A questionnaire survey of TB patients was performed,and a conditional logistic regression analysis was used for data analysis.Results The univariate analysis showed that there were significant differences between the two groups in family income,low weight(BMI＜18.5) educational level,tuberculosis contact history,irregular treatment of tuberculosis,diabetes history and retreatment of tuberculosis (P＜0.05).The multivariate logistic regression analysis indicated that the low level of family income (OR=1.667,95％ CI=1.105-2.391),tuberculosis contact history (OR=3.471,95％ CI=2.230-5.314) and irregular treatment of tuberculosis (OR=4.836,95％CI=3.119-7.538) were the main risk factors.Conclusion The targeted measures should be taken to improve treatment compliance of TB patients,and the authority should take more supports for poorpatients.