2017-2019年威海市肺结核患者耐药状况及影响因素分析  

Analysis on drug resistance and influencing factors of pulmonary tuberculosis patients, Weihai city,2017-2019

作　　者：王淑萍[1] 林海霞 WANG Shu-ping;LIN Hai-xia(Weihai City Center for Disease Control and Prevention,Weihai,Shandong,264200,China;不详)

机构地区：[1]威海市疾病预防控制中心,山东威海264200 [2]威海市胸科医院,山东威海264200

出　　处：《预防医学论坛》2021年第12期932-934,共3页Preventive Medicine Tribune

摘　　要：目的了解威海市肺结核患者耐药状况及相关影响因素,为制定耐药结核病控制策略提供参考依据。方法收集2017-2019年市、县级结防机构实验室登记的647例耐药可疑者为研究对象,采用比例法对一线抗结核药异烟肼、利福平和二线抗结核药氧氟沙星、卡那霉素进行敏感性试验,分析耐药率及影响因素。结果威海市登记耐药可疑者647例,除去资料缺失、污染等15例处,最终有632例,经菌种鉴定,527例为结核分枝杆菌。结核分枝杆菌总耐药率为26.57%(140/527),耐多药率为11.95%(63/527);初治肺结核患者耐药率为17.37%(66/380),耐多药率为4.74%(18/380);复治肺结核患者耐药率为50.34%(74/147),耐多药率为30.61%(45/147);多因素Logistic回归结果显示,30~39岁组(OR=3.39,95%CI=1.23~9.31),治疗史(OR=10.63,95%CI=5.60~20.17)是耐多药发生的主要危险因素(P<0.05)。结论威海市的耐多药结核病疫情较严重,复治患者、30~39岁组是耐药的相关危险因素。Objective To understand the drug resistance status and related influencing factors of tuberculosis patients in Weihai city,so as to provide reference for the development of drug resistant tuberculosis control strategy.Methods A total of 647 patients with suspected drug resistance registered in municipal and county level prevention and control institutions from 2017 to 2019 were collected as research subjects.The sensitivity tests of first line anti-tuberculosis drugs isoniazid,rifampicin and second line anti-tuberculosis drugs ofloxacin and kanamycin were conducted by proportional method,and drug resistance rates and influencing factors were analyzed.All data were analyzed using Excel 2007 and SPSS16.0 software.Results The total drug resistance rate of Mycobacterium tuberculosis in Weihai was 26.57%(140/527),and the multidrug resistance rate was 11.95%(63/527).The drug resistance rate of initial pulmonary tuberculosis was 17.37%(66/380),and the multi-drug resistance rate of initial pulmonary tuberculosis was 4.74%(18/380).The drug resistance rate of retreated pulmonary tuberculosis was 50.34%(74/147),and the multi-drug resistance rate of retreated pulmonary tuberculosis was 30.61%(45/147).Multivariate logistic regression results showed that the age group of 30-39 years old(OR=3.39,95%CI=1.23-9.31)and treatment history(OR=10.63,95%CI=5.60-20.17)were the main risk factors for the occurrence of multi-drug resistance in Weihai city(P<0.05).Conclusion Weihai multi-drug resistant tuberculosis epidemic situation is very serious.The retreatment patients and 30-39 groups are risk factors related to drug resistance.

关 键 词：肺结核 耐多药 危险因素 

分 类 号：R521[医药卫生—内科学]