天津市滨海新区社区中老年人群肺结核耐药菌分布及危险因素的logistic回归分析  

Distribution of tuberculosis drug resistant bacteria and logistic regression analysis of risk factors among community elderly people in Binhai new area of Tianjin

作　　者：张东芳 张琴 刘国敏 

机构地区：[1]天津市滨海新区汉沽疾病预防控制中心结核病防控科,300480

出　　处：《职业与健康》2015年第20期2786-2788,共3页Occupation and Health

摘　　要：目的对天津市滨海新区社区中老年人群中患肺结核的临床资料进行回顾性分析,探讨老年肺结核患者耐药菌群分布情况及导致耐药菌感染的危险因素。方法采用随机抽样的方法,抽取2012—2014年社区门诊病历和海河医院住院病历263例中老年肺结核患者的临床资料,对患者耐药菌感染率、耐药菌群分布及导致耐药菌感染的危险因素进行分析。结果在263例患者中,有51例患者为耐药菌感染,感染率为19.39%。仅对1种药物耐药者最多,占45.10%(23例);其次2及3种耐药者,各占23.53%(各12例);4种耐药者最低,占7.84%(4例)。对异烟肼耐药者最多,占27.27%(27例);其次为利福平耐药者,占22.22%(22例);而水杨酸耐药者最低,为6.66%(6例);差异有统计学意义(P<0.01)。药物依从性、吸烟及糖尿病病史均为导致社区中老年人群患肺结核的危险因素(P<0.05)。结论天津市滨海新区社区中老年肺结核患者的耐药菌感染发病率较高,且以单独1种药物耐药及耐异烟肼药物者居多,同时其发病与治疗中断、依从性差、吸烟及糖尿病病史密切相关,临床应注意以上因素。[Objective]To analyze the clinical data of community elderly people with tuberculosis in Binhai new area of Tianjin,explore the distribution of drug resistant bacteria and risk factors lead to drug resistant bacteria infection among elderly people with tuberculosis. [Methods]The clinical data of 263 elderly pulmonary tuberculosis patients were collected from community outpatient records and Haihe river hospital medical records from 2012-2014 by random sampling methods. The infection rate of drug resistant bacteria,distribution and risk factors were analyzed. [Results]Among 263 patients,51 patients were drug resistant bacteria infection,the infection rate was 19.39%. The patients who were only resistant to one drug was the highest,accounted for45.10%（23 cases）,resistant to two or three drugs accounted for 23.53%（12 cases） respectively,resistant to four drugs was the lowest,accounted for 7.84%（4 cases）. The patients who were resistant to isoniazid was the highest,accounted for 27.27%（27cases）,followed by rifampicin,accounted for 22.22%（22 cases）,salicylic acid was the lowest,accounted for 6.66%（6 cases）,the difference was statistically significant（P〈0.01）. Drug compliance,smoking and diabetes history were the risk factors lead to community elderly people suffering from tuberculosis（P〈0.05）. [Conclusion]The incidence rate of drug resistant bacteria infection among community elderly people in Binhai new area of Tianjin is higher, and the patients who are resistant to one drug or isoniazid are the most. The onset is related to treatment interrupted, poor compliance, smoking and diabetes history, which should be paid attention in clinical.

关 键 词：中老年人群 肺结核 耐药菌群检出率 抗结核药物 危险因素 

分 类 号：R181[医药卫生—流行病学]