河南省耐多药和非耐多药结核病对患者社会生活影响的比较

目的 调查研究并比较河南省耐多药结核病(MDR-TB)和非耐多药结核病(非MDR-TB)对患者社会生活的影响，为制订综合有效的结核病防治策略提供科学依据。 方法 利用2001年河南省参加世界卫生组织结核病耐药监测调查患者数据库, 采用Excel生成随机数字表方法随机抽取入选患者。使用问卷面对面访谈形式于2010年对MDR-TB患者和非MDR-TB患者的社会经济状况及结核病相关情况进行访谈性调查研究；共调查访谈234例TB患者。按照对异烟肼和利福平的耐药状态分为暴露组（MDR-TB患者组）86例和对照组（非MDR-TB患者组）148例。对收集的数据进行t检验和卡方检验。 结果 暴露组（70.9%，61/86）对患结核病的态度比对照组（52.4%，77/148）明显悲观，两组间差异有统计学意义（χ²=8.58，P=0.01）。与对照组比较（2.0%, 3/148），更多暴露组患者在患病期间依旧外出打工（9.3%，8/86），两组间差异有统计学意义（χ²=6.43，P=0.01）。结核病治愈后暴露组外出打工的比例（8.8%，7/80）明显低于对照组（24.0%，35/146），两组间差异有统计学意义（χ²=7.92，P<0.01）。与对照组相比（18.9%，28/148），更多暴露组患者患结核病后仍吸烟 (34.9%，30/86)，两组间差异有统计学意义（χ²=7.44，P<0.01）。更高比率的暴露组患者报告其未来生活计划被患结核病所改变（45.8%，33/72），相比之下23.9%(27/113) 的对照组报告其未来生活计划被改变，两组间差异有统计学意义（χ²=11.67，P<0.01）。 结论 与对照组患者相比，暴露组患者在患病后的社会生活受到明显影响。因此，建议为更加有效的控制结核病尤其是耐多药结核病，应进一步加强对MDR-TB患者的社会支持。

The social impacts of MDR-TB on patients compared to non-MDR-TB in Henan province

Objective To investigate the social impacts of MDR-TB and compare to non-MDR-TB in Henan province in 2010 to provide scientific evidence for developing comprehensive TB control strategies. Methods Participants were randomly selected by using Excel generated random digits table from an anti-TB drug resistance surveillance survey dataset collected by the Institute for Tuberculosis Control and Prevention, Henan Centre for Disease Control and Prevention in 2001, supported by the World Health Organization. Face to face interviews were carried out using a questionnaire to collect information on the social impacts among MDR-TB and non-MDR-TB patients.Bivariate analysis was performed for data analysis. Altogether 234 TB cases were interviewed. Among the interviewed cases, 86 were MDR-TB cases and 148 were non-MDR-TB cases based on their anti-TB drug resistance status. T-test was applied in continuous variables and Chi square test was used for categorical variables for comparison. Results Compared to non-MDR-TB （52.4%, 77/148）, a greater proportion of MDR-TB patients （70.9%,61/86） reported pessimism （χ^2=8.58, P=0.01）. More MDR-TB patients （9.3%, 8/86） continued working outside when they were ill with TB compared to non MDR-TB patients （2.0%, 3/148） and the difference was statistically significant （χ^2 =6.43, P=0.01）. However, after TB recovery, less MDR-TB patients （8. 8%, 7/80） were able to work outside compared to non-MDR-TB patients （24.0%, 35/146）, and the difference between the two groups was statistically significant （χ^2= 7.92, P〈0.01）. Compared to non-MDR-TB patients （18.9%, 28/148）, more MDR-TB patients （34.9%, 30/86） maintained their smoking habit after they became ill with TB （χ^2=7.44,P〈0.01）. A substantially greater proportion of MDR TB patients reported future plans changed because of the dis- ease compared to non-MDR-TB patients （45.8%, 33/72 vs 23.9%, 27/113, χ^2 = 11.67, P〈0.01）. Conclusion The findings from this study suggest that social support to TB patients, especially Mf）R-TB patients is an important factor to be concerned when designing a comprehensive TB program.