耐多药肺结核患者氟喹诺酮耐药因素分析  

Analysis of factors for fluoroquinolones resistance in patients with multidrug-resistant tuberculosis

作　　者：梁雅雪 王华[1] LIANG Yaxue;WANG Hua(Anhui Chest Hospital,Clinical College of Chest,Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽省胸科医院,安徽医科大学胸科临床学院,合肥230022

出　　处：《实用医学杂志》2022年第13期1604-1608,共5页The Journal of Practical Medicine

基　　金：“十三五”国家科技重大专项“艾滋病和病毒性肝炎等重大传染病防治”专项课题(编号:2018ZX10302302-001-007)。

摘　　要：目的观察耐多药肺结核(MDR-PTB)患者的临床特征,分析MDR-PTB形成氟喹诺酮类(FQs)耐药的危险因素。方法收集安徽省胸科医院2019年4月至2021年3月收治的230例MDR-PTB患者,按照耐药类型分为两组:FQs敏感组、FQs耐药组,采用χ^(2)检验进行组间比较分析形成FQs耐药的影响因素,并进行多因素logistic回归分析筛选出独立危险因素。结果治疗类型、二线抗结核药物使用情况、合并症、胸部CT表现、体质量指数(BMI)、年龄等是MDR-PTB患者形成FQs耐药的影响因素(均P<0.05),多因素logistic回归分析显示二线抗结核药物使用史及BMI<18.5 kg/m^(2)是MDR-PTB患者发生FQs耐药的独立危险因素(均P<0.05)。结论既往使用过二线药物及BMI<18.5 kg/m^(2)是MDR-PTB患者形成FQs耐药的独立危险因素,对临床快速诊断及鉴别诊断FQs耐药肺结核有一定的参考价值。Objective To investigate the characteristics of the patients with multidrug-resistant pulmonary tuberculosis(MDR-PTB)and analyze the risk factors for developing the resistance of fluoroquinolones(FQs).Methods A total of 230 MDR-PTB patients admitted to Anhui Chest Hospital from April 2019 to March 2021were collected and divided into the FQs sensitive group and the FQs resistant group according to the type of drug resistance.The chi-square test was used for comparative analysis of the factors related to FQs resistance,and multivariate logistic regression analysis was conducted to screen out independent risk factors.Results The chisquare test showed the risk factors related to FQs resistance were the type of treatment,the use of second-line antituberculosis drugs previously,comorbidities,chest CT findings,body mass index(BMI)and age(P<0.05 for all).Multivariate logistic regression analysis showed the use of second-line anti-tuberculosis drugs previously and BMI<18.5 kg/m^(2)were independent risk factors(P<0.05 for both).Conclusion The use of second-line anti-tuberculosis drugs previously and BMI<18.5 kg/m^(2)are independent risk factors for developing FQs drug resistance in MDRPTB patients,which has certain reference value for clinical rapid diagnosis and differential diagnosis of FQs resistant tuberculosis.

关 键 词：肺结核 耐多药肺结核 氟喹诺酮类 危险因素 

分 类 号：R521[医药卫生—内科学]