四川和安徽两省结核耐药危险因素分析

目的 了解四川和安徽两省继发性耐药结核患者产生的主要社会行为危险因素,为预防耐药性结核病的发生提供依据.方法 选取四川和安徽两省结核病防治所就诊的结核患者1489例,四川875例,安徽省614例.其中继发耐药结核患者356例.采用问卷调查患者可能导致继发性耐药结核的主要社会行为危险因素,并对其危险因素进行logistic回归分析.结论 四川和安徽两省继发耐药结核产生的主要社会危险因素为患者治疗时间长、督导化疗不彻底、患者治疗中依从性差、药品供应不满意、流动人口、治疗过程中有中断和治疗过程中经常饮酒.其比值比及可信区间分别为10.279(6.842～17.663)、 9.880(6.743～16.672)、 4.683(1.935～9.523)、3.859(1.584～9.218)、5.030(2.683～10.891)、4.938(2.162～9.982)和2.338(1.084～7.116).结论 加强对继发性耐药的社会行为危险因素的预防干预,对减少耐药结核的产生具有重要的意义.

Analysis on Risk Factors of Drug Resistance for Tuberculosis in Sichuan and Anhui Provinces

Objective To investigate the risk factors associated with secondary drug resistance for Tuberculosis(SDR-TB).Methods A total of 1489 patients with TB were recruited in this study,among which 875 sought medical attentions from the institute of TB control and prevention of Sichuan province;614 sought medical attentions from the institute of TB control and prevention of Anhui province;356 of the patients were identified as SDR-TB.Questionnaire surveys and Logistic Regression Analysis were undertaken to investigate the social behavioral risk factors associated with SDR-TB.Results The length of suffering,incomplete directly observed treatment(DOTS),poor patient compliance,unsatisfied supply of medicines,floating population,interruption of treatment,and alcohol drinking were identified as major social behavioral risk factors of SDR-TB.The Odds Ratios(OR) and Confidence Intervals(CI) for the above factors were 0.279(6.842-17.663),9.880(6.743-16.672),4.683(2.335-10.523),3.859(1.584-9.218),5.030(1.683-9.891),4.938(2.162-9.982) and 2.338(1.284-7.116) respectively.Conclusion The results of this study has implications for improving the prevention and control of TB,in particular,for the SDR-TB.