肺结核耐药情况及影响因素分析

目的探讨肺结核耐药情况及影响因素,为制定结核病相关防控措施提供依据。方法选取2017年1月—12月在我院治疗的痰涂片阳性患者320例,采用比例法检测痰涂片阳性患者对一线抗结核药物敏感性,同时收集患者性别、年龄等一般资料。结果 320例患者中,共检测到耐药患者56例,耐药率为17.50%,其中单耐药率8.13%,多耐药率2.50%,耐多药率6.88%;耐药患者复治、非规律治疗比例分别为62.50%和66.07%,明显高于非耐药患者(P均0.05);耐药与非耐药患者在性别、年龄、户籍、糖尿病及高血压病史方面相比,差异无统计学意义(P均0.05);Logistic回归分析结果显示,复治、非规律治疗是肺结核患者发生耐药的危险因素(OR=3.047和2.812,P均0.05)。结论肺结核患者耐药情况较严重,复治以及非规律治疗是肺结核产生耐药的危险因素,故在结核病防控中应积极提高初治治愈率,加强患者健康教育,提高治疗依从性。

Analysis of drug resistance and influencing factors of pulmonary tuberculosis

Objective To explore the drug resistance and influencing factors of pulmonary tuberculosis and provide the basis for the formulation of prevention and control measures for tuberculosis. Methods A total of 320 sputum smear positive patients who were treated in our hospital from January 2017 to December 2017 were selected, and the sensitivity of first-line anti-tuberculosis drugs of sputum smear positive patients was detected by proportion method. Meanwhile, general data of the patients including gender and age were collected. Results Among the 320 patients, 56 cases of drug resistance were detected, accounting for drug resistance rate of 17.50%, of which mono-drug resistance rate was 8.13%, poly-drug resistance rate was 2.50%, and multi-drug resistance rate was 6.88%; The rates of retreatment and irregular treatment in drug resistant patients were 62.50% and 66.07%, respectively, which were significantly higher than those of non-drug resistant patients (P ＜ 0.05). There were no significant differences in gender, age, household registration, history of diabetes and history of hypertension between drug resistant patients and non-drug resistant patients (P＞0.05). The results of Logistic regression analysis showed that retreatment and irregular treatment were the risk factors of drug resistance in patients with pulmonary tuberculosis (OR=3.047 and 2.812, P ＜ 0.05). Conclusions Drug resistance is more serious in patients with pulmonary tuberculosis. Retreatment and irregular treatment are risk factors for drug resistance of tuberculosis. Therefore, the prevention and control of tuberculosis should focus on active increase of cure rate of initial treatment, enhancement of health education for patients and improvement of treatment compliance.