兰州市1 536例确诊肺结核患者耐多药情况及影响因素  

Prevalence and influencing factors of multi-drug resistance among 1536 tuberculosis patients in Lanzhou City

作　　者：张宇琦 王智永 李宗煜 高文龙[1] 李明 罗秋霞 向媛媛 包凯 ZHANG Yuqi;WANG Zhiyong;LI Zongyu;GAO Wenlong;LI Ming;LUO Qiuxia;XIANG Yuanyuan;BAO Kai(Department of Epidemiology and Health Statistics,School of Public Health,Lanzhou University,Lanzhou 730000,China;Lanzhou Pulmonary Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学公共卫生学院流行病与卫生统计学研究所,兰州730000 [2]兰州市肺科医院,兰州730030

出　　处：《中华疾病控制杂志》2023年第7期854-857,共4页Chinese Journal of Disease Control & Prevention

基　　金：兰州市人才创新创业(2020-RC-76)。

摘　　要：目的探索1536例肺结核患者的耐多药状况及其影响因素。方法数据资料来自2018―2020年结核病管理信息系统中登记管理的兰州市1536例确诊肺结核患者。利用χ^(2)检验和多因素logistic回归分析模型分析探索肺结核患者耐多药的影响因素。结果1536例肺结核患者中,耐药患者445例(29.0%),耐多药患者327例(21.3%)。单因素分析结果显示,不同性别、年龄、民族、职业、户籍类型和登记分类间患者耐多药情况的差异均有统计学意义(均P<0.05)。多因素logistic回归分析模型分析结果显示,职业为农牧民及工人(OR=2.95,95%CI:1.32~6.59,P=0.008)、其他职业(OR=3.12,95%CI:1.41~6.88,P=0.005)、登记分类为复发(OR=6.16,95%CI:3.66~10.39,P<0.001)、复治失败(OR=11.93,95%CI:4.61~30.88,P<0.001)和初治失败(OR=14.10,95%CI:7.74~25.69,P<0.001)的患者出现耐多药可能性较高;而兰州市户籍患者发生耐多药的可能性较低(OR=0.11,95%CI:0.08~0.16,P<0.001)。结论兰州市肺结核患者耐多药率较高。农牧民及工人、其他职业、非兰州市户籍、复发、初治失败和复治失败是发生耐多药的主要危险因素。Objective The goal of this research was to investigate the prevalence of multi-drug resistance and its influencing factors in 1536 tuberculosis patients.Methods A total of 1536 confirmed tuberculosis patients were recruited in Lanzhou from 2018 to 2020,using the Tuberculosis Management Information System.Chi-square test and multivariate logistic regression analysis were used to explore the influencing factors of multi-drug resistance.Results Among the 1536 tuberculosis patients,there were 445(29.0%)cases presented with drug-resistant tuberculosis and 327(21.3%)cases with multidrug-resistant tuberculosis.The results of univariate analysis showed that there were significant differences in multidrug-resistant status among patients with different genders,ages,nationalities,occupations,household registration types,and registered classifications.Multivariate logistic regression analysis showed that those working as farmers,herdsmen,workers(OR=2.95,95%CI:1.32-6.59,P=0.008)and other occupations(OR=3.12,95%CI:1.41-6.88,P=0.005),as well as patients classified as relapse(OR=6.16,95%CI:3.66-10.39,P<0.001),retreatment failure(OR=11.93,95%CI:4.61-30.88,P<0.001)and initial treatment failure(OR=14.10,95%CI:7.74-25.69,P<0.001)were more likely to develop multi-drug resistance.Converserly,patients registered as residing in Lanzhou were less likely to develop multi-drug resistance(OR=0.11,95%CI:0.08-0.16,P<0.001).Conclusions The prevalence of MDR in tuberculosis patients in Lanzhou was found to be high.Occupations such as farmers,herdsmen,and workers,along with other occupations,non-Lanzhou household registration,and classifications of relapse,initial treatment failure,and retreatment failure were identified as major risk factors for developing MDR.

关 键 词：肺结核 耐多药肺结核 logistic回归分析模型 影响因素 

分 类 号：R521[医药卫生—内科学]