深圳市耐多药结核患者二线药物耐药及相关因素分析  

The prevalence and risk factors on the resistance to second-line drugs in patients with MDR-TB in Shenzhen

作　　者：洪创跃[1] 李金莉[1] 杨争 朱玉梅[1] 余卫业 HONG Chuangyue;LI Jinli;YANG Zheng;ZHU Yumei;YU Weiye(Shenzhen Center for Chronic Diseases Control,Shenzhen,Guangdong 518020,China)

机构地区：[1]广东省深圳市慢性病防治中心,广东深圳518020

出　　处：《公共卫生与预防医学》2019年第1期103-105,共3页Journal of Public Health and Preventive Medicine

基　　金：深圳市卫生计生系统重点学科建设能力提升项目(201606044)

摘　　要：目的分析深圳市耐多药患者(MDR-TB)二线药物耐药状况以及其相关危险因素。方法选择2015—2017年深圳市耐药监测项目中的MDR-TB作为研究对象,采用比例法检测所有菌株的二线药物(氧氟沙星、阿米卡星、卡那霉素、卷曲霉素、对氨基水杨酸钠和丙硫异烟胺)敏感性,并通过单因素和多因素分析MDR-TB二线药物耐药性的危险因素。结果 209例MDR-TB患者中,有96例(45.93%)至少对1种二线药物产生耐药,其中氧氟沙星的耐药率最高,为30.62%(64/209),有4例为广泛耐药患者(XDR-TB)。多因素分析结果显示,45～59岁为MDR-TB二线药物耐药的危险因素(OR=2.125,95%CI:0.580～7.783,χ~2值=15.325,P值=0.001<0.05)。结论深圳市MDR-TB患者中二线药物耐药情况严重,45～59岁为二线药物耐药的相关危险因素。Objective To determine the prevalence and risk factors on second-line drug resistance in patients with multidrug resistant tuberculosis(MDR-TB)in Shenzhen.Methods The MDR-TB patients from Shenzhen Drug Resistance Surveillance Project during 2015-2017 were selected as the study subjects.Drug sensitivity testing on second-line anti TB drugs(ofloxacin,amikacin,kanamycin,capreomycin,p-aminosalicylic acid and prothionamide)was routinely performed on all tuberculosis strains.Logistic regression analysis was conducted to determine the risk factors for second-line drug resistance.Results A total of 209 patients with MDR-TB was investigated during the study period,in which 96 cases(45.93%)showed resistance to at least one of the second-line drugs tested and 4 cases were extensively drug resistant patients.Among the second-line anti TB drugs,ofloxacin has the highest resistance rate(30.62%,64/209).The multivariate analysis showed that MDR-TB patients aged 45-59 were significantly more likely to develop resistance to second line drugs(OR=0.235,OR=2.125,CI:0.580-7.783,χ^2=15.325,P=0.001<0.05).Conclusion The prevalence of second line drug resistance among MDR-TB patients was high in Shenzhen.The age of 45-59 years was an important risk factor for the resistance to second-line drugs.

关 键 词：深圳市 耐多药结核病 危险因素 二线抗结核药物 

分 类 号：R183.3[医药卫生—流行病学]