结核病人临床单耐药及风险因素回归分析

    Analysis of single drug-resistance and risk factors in tuberculosis patients

    • 摘要:
      目的分析近年结核病单耐药趋势及其风险因素,为临床医务工作者早期发现耐药结核病提供参考依据。
      方法收集2015-2017年就诊于阜阳市传染病医院并接受住院治疗的肺结核病人的相关资料,对其四种一线抗结核药的单耐药率趋势进行分析,进一步探究单耐药相关临床特征及风险因素。
      结果一线抗结核药物异烟肼、利福平、乙胺丁醇和链霉素的耐药率3年均未发现上升或下降的变化趋势(P>0.05)。来源地农村、有结核接触病史、CT示肺部有空洞、双肺受累、合并有慢性阻塞性肺疾病和长期使用激素能够增加肺结核病人耐药发生的风险(P < 0.05~P < 0.01)。
      结论对农民、有结核接触病史、CT示有空洞、双肺受累、合并有慢性阻塞性肺疾病和长期使用激素者,需要及时做耐药检测,以对单耐药结核病人采取针对性的治疗。

       

      Abstract:
      ObjectiveTo analyze the trend and risk factors of single drug-resistance in tuberculosis(TB) patients in recent years, and provide a reference for the early detection of drug-resistance tuberculosis.
      MethodsThe clinical data of the TB patients from the Fuyang Infectious Disease Hospital from 2015 to 2017 were collected, the single drug-resistance trend of four kinds of first-line anti-TB drug was analyzed, and the clinical characteristics and risk factors associated with single drug-resistance were further investigated.
      ResultsThe drug-resistance rates of isoniazid, rifampicin, ethambutol and streptomycin of the first-line anti-TB drugs did not increase or decrease within 3 years(P>0.05).The farmers, history of TB exposure, pulmonary cavities, bilateral lung involvement, complicated with chronic obstructive pulmonary disease and long-term hormone use could increase the risk of drug-resistance in TB patients(P < 0.05 to P < 0.01), and the concomitant diabetes was a protective factor in the development of drug-resistance TB(P < 0.01).
      ConclusionsThe drug-resistance in the farmers, history of TB exposure, pulmonary cavities, bilateral lung involvement, complicated with chronic obstructive pulmonary disease and long-term hormone use patients should timely be detected, and the targeted treatment for single drug-resistance TB patients should be implemented.

       

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