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383例耐药肺结核患者的相关危险因素分析
Analysis on the risk factors of 383 patients with drug-resistant pulmonary tuberculosis
【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。
【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 1st month(χ2=21.62,P<0.001)and culture results at the end of the 2nd 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 2nd 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 2nd month are the risk factors of drug-resistant occurrence with culture-positive originally.
【Key words】 Tuberculosis,pulmonary; Tuberculosis,multidrug-resistant; Risk factors;
- 【文献出处】 结核病与肺部健康杂志 ,Journal of Tuberculosis and Lung Health , 编辑部邮箱 ,2016年02期
- 【分类号】R521
- 【下载频次】36