深圳市结核病耐药情况及影响因素分析  

Analysis of the situation of anti-TB drug resistance and its risk factors in Shenzhen City

作　　者：许丽[1] 杨应周[1] 吕德良[1] 吴清芳[1] 李明珍[1] 张玉华[1] 

机构地区：[1]深圳市慢性病防治中心,广东深圳518020

出　　处：《中国热带医学》2010年第11期1333-1335,共3页China Tropical Medicine

基　　金：国家十一五重大专项"宝安区防治结核病规模化现场流行病学和干预的研究";(课题编号:2009ZX10003-018)

摘　　要：目的了解深圳市结核分枝杆菌耐药情况及耐药产生的影响因素,为制定科学的耐药结核病预防控制策略提供依据。方法以深圳市2008年间新登记的结核分枝杆菌感染的涂阳肺结核病人为研究对象,用比例法进行药物敏感试验获得结核分枝杆菌耐药信息,并通过问卷调查获得患者其他相关信息;单因素分析采用卡方检验、方差分析、Kruskal-Wallis秩和检验,多因素分析采用多分类Logistic回归分析。结果 759例结核分枝杆菌感染的涂阳肺结核患者中,总耐药率为17.52%(133/759),耐多药率为5.14%,单耐药率为9.88%,多耐药率为2.50%。多分类Logistic回归分析显示影响结核分支杆菌耐药性的因素有3个:登记分类、流动人口以及饮酒史。结论深圳市耐药结核病疫情相对严重,加强对复治患者、外来人口和经常喝酒的涂阳肺结核患者的耐药性筛查及治疗管理。Aim To understand the status of drug resistance （DR） of Mycobacterium tuberculosis and multi drugresistance （MDR-TB） situation and its risk factors in Shenzhen. Methods The new registered smear positive cases in 2008 with clinical Mycobacterium tuberculosis isaolates were surveyed. Drug susceptibility was tested by the proportion method. Demographic characteristic was surveyed by questionnaire. The risk factors concerning developing anti-TB drugs, multinomial logistic regression model was used in multivariate analysis. Results Among 769 clinical isolated strains, 759 cases were Mycobacterium tuberculosis cases,accounted for 98.70%. The total DR rate was17.52%（133/759）,and MDR-TB was 5.14%,the resistance to any single drug was 9.88%,and rate of resistance to one or more antiTB drugs was 2.50%. The multinomial logistic regression analysis showed that there were 3 influencing factors for drug-susceptibility of Mycobacterium tuberculosis： retreatment,tlowing population,and history of drinking. Conclusion The incidence of drug resistance of Mycobacterium tuberculosis in Shenzhen is relatively high. Retreatment,flowing population and alcohol addict were the risk factors associated with development of anti-TB drug resistance.

关 键 词：分枝杆菌 结核 耐药 危险因素 深圳 

分 类 号：R521[医药卫生—内科学]