海南省92例肺结核耐药的危险因素分析

目的 探讨海南省92例肺结核发生耐药的相关危险因素。方法 收集海南省92例耐药的肺结核患者(耐药组)和120例非耐药的肺结核患者(非耐药组)的临床资料(性别、年龄、居住地、初/复治、治疗过程是否中断、结核病诊断治疗史、第一次是否在结核病定点医疗机构就诊)进行统计学处理,把有统计学意义的因素进行多因素非条件Logisitic回归分析,探讨肺结核发生耐药的相关危险因素。结果 肺结核耐药的发生与患者的性别、年龄无关(P>0.05),与居住地、初/复治、治疗过程是否中断、有结核病诊断治疗史,第一次在非结核医疗定点机构就诊有关(P<0.01);多因素非条件Logisitic回归分析显示,居住地为农村(OR=2.467 95%CI=1.309~4.650)、复治(OR=4.046 95%CI=2.274~7.199)、治疗过程曾经中断(OR=5.195 95%CI=2.877~9.381)、有结核病诊断治疗史(OR= 7.792 95%CI=4.206~14.436)和第一次在非结核医疗定点机构就诊(OR=5.495 95%CI=3.038~9.938)是产生耐多药结核病的危险因素。结论 居住地为农村、复治、曾经中断治疗、有结核病诊断治疗史、第一次在非结核病定点医疗机构就诊的肺结核患者易出现耐药性。

Risk factors of drug resistance in 92 pulmonary tuberculosis cases in Hainan

Objective To investigate the risk factors of drug resistance of 92 pulmonary tuberculosis (TB) cases in Hainnan Province. Methods The clinical information (gender, age, place of residence, beginning/retreatment, the course of treatment being interrupted or not, history of TB diagnosis and treatment, the first visit to a designated TB medical institution or not) of 92 drug-resistant pulmonary TB patients (a resistance group) and 120 non-drug resistant pulmonary TB patients (a non-resistance group) was collected and statistically analyzed in Hainan Province. The multivariate non conditional logistic regression analysis was performed to analyze the statistically significant factors to find the related factors of drug resistance of pulmonary TB. Results The drug resistance of pulmonary TB was not associated with the gender and age (P>0.05), but was related to the place of residence, beginning/retreatment, the course of treatment being interrupted or not, history of TB diagnosis and treatment, the first visit to a non-designated TB medical institution (P<0.01). The multivariate non conditional logistic regression analysis showed that the residence place of rural area (OR=2.467, 95%CI=1.309-4.650), retreatment (OR=4.046, 95%CI=2.274-7.199), the course of treatment being interrupted (OR=5.195, 95%CI=2.877-9.381), history of TB diagnosis and treatment (OR=7.792, 95%CI=4.206-14.436), and the first visit to a non-designated TB medical institution (OR=5.495, 95%CI=3.038-9.938) were the related factors of drug resistance of pulmonary TB. Conclusion The pulmonary TB patients with following risk factors: the residence place of rural area, retreatment, the course of treatment being interrupted, history of TB diagnosis and treatment, and the first visit to a non-designated TB medical institution are prone to having drug resistance.