重庆市复治肺结核合并糖尿病患者的耐药情况分析  

Analysis on drug resistance of retreatment pulmonary tuberculosis complicated with diabetes mellitus in Chongqing

作　　者：汪清雅 雷蓉蓉 庞艳 张婷 胡代玉 WANG Qing-ya;LEI Rong-rong;PANG Yan;ZHANG Ting;HU Dai-yu(Department of TB prevention and treatment,Chongqing institution of TB prevention and treatment,Chongqing 400050,China)

机构地区：[1]重庆市结核病防治所,重庆400050

出　　处：《现代预防医学》2020年第18期3442-3445,3456,共5页Modern Preventive Medicine

基　　金：重庆市卫生健康委医学科研项目(2015MSXM104)。

摘　　要：目的分析评价重庆市复治肺结核合并糖尿病患者的耐药情况。方法收集重庆市各区县结核病定点医疗机构在2014年1月-2017年9月期间开展耐药检测和糖尿病筛查的1 494例复治肺结核病例,用描述性流行病学进行分析,比较合并糖尿病病例与非合并糖尿病病例的耐药情况,并比较不同空腹血糖水平的复治肺结核合并糖尿病患者耐药情况。结果 1 494例复治肺结核患者中合并糖尿病者有189例,占12.65%,与非合并糖尿病组比较,合并糖尿病组平均年龄更大(t=6.630,P<0.001),且职业为离退休的比例更高,差异有统计学意义(χ~2=5.403,P<0.05)。合并糖尿病组总耐药率(40.74%vs35.63%)、单耐药率(10.05%vs6.13%)、耐多药率(26.46%vs24.37%)、利福平耐药率(30.69%vs27.66%)、单耐异烟肼率(6.35%vs3.22%),均高于非合并糖尿病组,其中利福平耐药率间差异(χ~2=4.591,P<0.05)及单耐异烟肼率间差异(χ~2=4.645,P<0.05)有统计学意义。在不同空腹血糖水平组别中,血糖水平大于14.0 mmol/L组耐药率、耐多药率最高,分别为46.43%、35.71%,其次为血糖水平为7.1~14.0 mmol/L组(44.12%、27.94%)、血糖水平小于7.1mmol/L组(16.00%、8.00%),其中血糖小于7.1 mmol/L组与血糖水平为7.1~14.0 mmol/L组的耐药率差异(χ~2=6.971,P<0.05)和耐多药率差异(χ~2=4.497,P<0.05)均有统计学意义,血糖小于7.1 mmol/L组与血糖大于14.0 mmol/L组的耐药率差异(χ~2=5.613,P<0.05)和耐多药率差异(χ~2=5.792,P<0.05)均有统计学意义。Objective To analyze and evaluate drug resistance of retreatment pulmonary tuberculosis complicated with diabetes mellitus in Chongqing.Methods We collected 1494 retreatment pulmonary tuberculosis cases from January 2014 to September 2017,which had carried out drug susceptibility test and diabetes screening in every district designated medical fa-cilities for tuberculosis of Chongqing.By descriptive epidemiological method,the drug resistance of patients with and without diabetes Mellitus were compared,and the drug resistance of retreatment pulmonary tuberculosis patients with diabetes Mellitus among different FBG levels were analyzed.Results Of 1494 retreatment pulmonary tuberculosis patients,189(12.65%)were TB-DM cases.TB-DM cases were more likely to be older(t=6.630,P<0.001),accompanied by higher percentage(x2=5.403,P<0.05)of retired person than TB-no DM cases(refers to TB patients without diabetes).The rate of total drug resistant TB(40.74%vs 35.63%),mono-resistant TB(10.05%vs 6.13%),multidrug resistant TB(MDR-TB,26.46%vs 24.37%),rifampin(RFP)-resistant TB(30.69%vs 27.66%),mono-Isoniazid(INH)-resistant TB(6.35%vs 3.22%)among TB-DM group were higher than TB-no DM group,there was significant difference in the rate of RFP-resistant TB between the two groups(χ~2=4.591,P<0.05),the same is true for mono-Isoniazid(INH)-resistant TB(χ~2=4.645,P<0.05).In different groups of fasting blood glucose(FBG)levels,the group of FBG higher than 14.0 mmol/L had the highest rates of total drug resistant TB and multidrug resistant TB(46.43%and 35.71%,respectively),followed by the group of FGB of 7.1 to 14.0 mmol/L(44.12%,27.94%)and the group of FGB less than 7.1 mmol/L(16.00%,8.00%).There were significant differences in total drug resistant TB(χ~2=6.971,P<0.05)and MDR-TB(χ~2=4.497,P<0.05)between the group of FGB less than 7.1 mmol/L and the group of FGB of 7.1 to 14.0 mmol/L and in total drug resistant TB(χ~2=5.613,P<0.05)and MDR-TB(x2=5.792,P<0.05)between the group of FGB higher than 14.0 mmol/L and the group of FGB of 7.1 to

关 键 词：复治肺结核 糖尿病 耐药 重庆市 

分 类 号：R118[医药卫生—公共卫生与预防医学]