新疆喀什地区肺结核患者产生耐药的危险因素分析

目的分析新疆喀什地区肺结核患者产生耐药的主要危险因素，为预防耐药性结核病的发生提供科学依据。方法选取2012年10月1日至2013年lO月1日新疆喀什地区结核病防治所收住人院的肺结核患者758例，其中耐药肺结核患者209例。对758例患者进行问卷调查，共获得有效问卷721份，问卷回收率为95．12％；获取患者可能导致耐药肺结核的主要危险因素，并对其危险因素进行logistic回归分析。结果多因素logistic回归分析结果表明，肺结核患者病程长（OR—10．725，95％CI=5．903～17．326）、DOTS执行不彻底（OR-9．080，95％CI=6．531～17．017）、治疗过程有中断（OR-5．013，95％CI-2．526～9．026）、患者治疗的依从性差（OR--4．683，95％CI=1．935±9．523）、患者合并营养不良（OR=3．959，95％CI=1．984±9．081）、患者合并2型糖尿病（OR-5．002，95％CI=1．993410．019）及肺结核患者有结核性空洞（0R-2．528，95％CI=1．648～7．001）发生耐药结核病的风险较高。结论根据上述产生耐药结核病的危险因素，必须有针对性地采取相应的防治措施。

Analysis on risk factors of drug resistance for pulmonary tuberculosis in Kashgar prefecture of Xinjiang Uygur Autono-mous Region

Objective To analyze the risk factors associated with drug resistance of pulmonary tuberculosis （PTB） patients in Kashgar prefecture of Xinjiang Uygur Autonomous Region, and provide scientific evidence for DR-PTB control. Methods A total of 758 PTB patients hospitalized in TB Institute of Kashgar prefecture be- tween 1 October 2012 and 1 October 2013 were recruited in this study, among them, 209 were identified as DR-PTB. Questionnaires were administered to 758 patients, 721 responded with the valid response rate of 95.12%. Logistic regression analysis were used to investigate the risk factors associated with DR-PTB. Results The multivariate analysis showed that PTB patients with longer duration of tuberculosis（OR= 10. 725,95 %CI= 5. 903- 17. 326）, in complete directly observed treatment（DOTS） （OR= 9. 080,95%CI= 6. 531 - 17. 017）, poor patient compliance（OR= 4. 683,95 %0 CI： 1. 935 = 9. 523）, treatment interruption（OR = 5.013,95 % CI = 2. 526 -- 9. 026 ）, malnutrition（（JR = 3. 959,95 %CI = 1. 984 -9. 081 ）, T2 DM （OR = 5. 002, 95 %0 C=- 1. 993 - 10. 019） and tuberculous cavity （OR = 2. 528,95%CI=1. 648--7. 001）were significantly more likely to have drug resistant PTB. Concision According to the risk factors of DR-PTB above, we should take effective and targeted prevention measures.