摘要
目的回顾性观察复治肺结核患者耐多药高危风险因素,以期降低本病发生率、提高防治效果。方法选取128例复治肺结核患者,其中复治肺结核耐多药者58例、敏感者70例,回顾性观察两类患者一般资料(性别、年龄、婚姻状况、文化程度、家庭收入等)、疾病资料(痰涂片结果、痰培养结果、X线胸片结果、药敏试验结果等)、生活工作条件(卫生习惯、居住环境、工作环境、工作暴露等)、个人喜好(吸烟、喝酒、饮食等)、结核治疗状况(首次治疗时间、治疗次数、中断次数、治疗结果等)、结核知识知晓(肺结核传播途径、临床症状、治疗方法等),引入二分类Logistic回归模型筛查复治肺结核患者耐多药高危风险因素。结果单因素风险比较显示户籍地、年龄、文化程度、阳光入室、结核病灶、空洞、病变累加肺野数、第一次用药持续时间、本次复发前接受抗结核治疗次数、抗结核治疗过程中断次数、最近一次用药效果、复治肺结核耐多药知晓率与同组比较,差异有统计学意义(P<0.05)。二分类Logistic回归模型筛查户籍地、年龄、文化程度、结核病灶数量、病变累加肺野数、第一次用药持续时间、本次复发前接受抗结核治疗次数、最近一次用药效果、复治肺结核耐多药知晓率是影响复治肺结核患者耐多药的高危风险因素。结论复治肺结核耐多药与户籍地、年龄、文化程度、结核病灶数量、病变累加肺野数、第一次用药持续时间、本次复发前接受抗结核治疗次数、最近一次用药效果、复治肺结核耐多药知晓率密切相关,积极对上述高危因素筛查有助于掌握本地区耐多药流行病学资料以及加强高危因素人群监管,从而有效降低复治肺结核耐多药发生率。
Objective To observe the high risk factors of retreated pulmonary tuberculosis patients withmulti-drug resistance respectively,in order to reduce the incidence of this disease and improve the control effect.Methods 128 cases of retreated pulmonary tuberculosis patients were selected, including 58 cases of retreated pul-monary tuberculosis patients witli multi-drug resistance and 70 sensitive cases. The data were ly,including general information （ sex,age,marital status,educational level,family income,etc. ）,disease data（sputum smear results,sputum culture results, X-ray findings, susceptibility test results） （ ing, etc. ）, tuberculosis treatment status （the first treatment time, the number of treatment, the number tion, treatment results, etc. ）, tuberculosis knowledge and awarenes of thie conditions of worl^ （ Pulmonsis transmission, clinical symptoms, treatment,etc. ） . A multi-nomial logistic regression model was used to screen the risk factors of multidrug resistance in retreated pulmonary tuberculosis patients. Results parison showed there was significant diference in the number of cases of household registration, age, educational lev-el ,sun room, tuberculosis, number of lesion, number of accumulated lung fields, duration of first medication, num-ber of antituberculosis treatment before relapse, discontinuation of anti-tuberculosis treatment, the last retreatment of tuberculosis resistant multi-drug awarenes, respectively （ P 〈 0. 05 ） . Logistic regression analysisshowed that the high risk factors included age, education level, number of tuberculosis lesions, cumulative lung field number of lesions,the duration of the first medication,the number of antituberculous treatmen the last drug use, retreatment of pulmonary tuberculosis （P〈0. 05 ） . Conclusion The number of TB lesions, cu-mulative lung fielcJ count, the duration of tlie first medication, the number of times before the relapse of anti-TB treat-ment ,the last drug effect, and multi-drug resistant awareness rate related to active screening of these high-risk factors will help to master tlie local epidemiolog of drug resistance data and strengtlien the supervision of high-risk popula-tion, so as to effectively reduce the incidence of retreated tuberculosis drug resistance.
出处
《临床肺科杂志》
2017年第12期2243-2247,共5页
Journal of Clinical Pulmonary Medicine
关键词
复治
肺结核
耐多药
高危
因素
retreatment
pulmonary tuberculosis
multidrug-resistant
high-risk
factor
