【摘要】 目的 探索肺结核患者的耐药状况及相关影响因素,为今后结核病防治工作提供参考依据。方法 采用统一设计的调查问卷对2008年10月至2010年12月期间在上海市、广东省、天津市、河北省、河南省、重庆市、广西壮族自治区及云南省等8个省(直辖市、自治区)共49个实施单位的1992例痰培养阳性肺结核病患者进行调查,运用卡方检验比较敏感和耐药患者在人口学特征、痰结核分枝杆菌检验结果、治疗转归等方面的差异,检验水准为0.05;运用多因素logistic回归分析筛选耐药肺结核发生的影响因素。结果 痰培养阳性的肺结核患者耐药率为19.2%(383/1992)。在对耐药肺结核患者进行单因素分析的基础上进行多因素非条件logistic分析,结果 表明复治及治疗2个月末培养阳性结核病患者是发生耐药结核病的危险因素,β值分别为0.593、0.786,sx值分别为0.172、0.191,Wald χ~2值分别为11.323、17.102,OR值(95%CI值)分别为1.789(1.312～2.398)和2.098(1.372～3.065),P值均<0.001。结论 复治及治疗2个月末培养阳性是痰培养阳性肺结核患者产生耐药的危险因素。更多还原

【Abstract】 Objective To explore the status of drug resistant tuberculosis（TB）and risk factors associated with drug-resistant pulmonary tuberculosis（PTB）,and provide evidence for tuberculosis control. Methods With unified questionnaire to investigate 1992 cases with culture-positive pulmonary tuberculosis from 49 organizations of Shanghai,Guangdong,Tianjin,Hebei,He’nan,Chongqing,Guangxi Zhuang Autonomous Region,Yunnan and other eight provinces from October 2008 to December 2010.Demographic characteristics,lab test,treatment outcome were analyzed using Chi-square test.Significance tests with P<0.05 were considered statistically significant.Multivariate logistic regression was used to explore risk factors of drug-resistance. Results Drug-resistant rate was 19.2%（383/1992）of culture-positive pulmonary tuberculosis.Univariate analysis showed that age（χ²=16.09,P<0.001）,education level（χ²=11.05,P=0.011）,occupation（χ²=13.79,P<0.001）,medical expenses expenditure type（χ²=8.511,P=0.037）,history of TB exposure（χ²=7.13,P=0.028）,type of treatment（χ²=20.97,P<0.001）,treatment outcome（χ²=24.37,P<0.001）,culture results at the end of the 1^st month（χ²=21.62,P<0.001）and culture results at the end of the 2^nd months（χ²=25.64,P<0.001）were statistically significant difference.The multivariate logistic analysis showed that retreatment and culture-positive at the end of 2^nd months were risk factors for the presence of drug-resistant tuberculosis.Theβvalues were 0.593 and 0.786,the sxvalues were 0.172 and 0.191,the Wald χ² values were 11.323 and 17.102,the ORvalues（95%CI）were 1.422（1.066-1.896）and 2.130（1.48-3.049）,respectively. Conclusion Retreatment and culture-positive at the end of the 2^nd month are the risk factors of drug-resistant occurrence with culture-positive originally.更多还原