[1]刘 莉,李 晋,马 云,等.肺结核348例耐药情况调查及影响因素分析[J].陕西医学杂志,2021,50(5):626-629,633.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.028]
　LIU Li,LI Jin,MA Yun,et al.Investigation of drug resistance in 348 cases of pulmonary tuberculosis and its influencing factors[J].,2021,50(5):626-629,633.[doi:DOI:10.3969/j.issn.1000-7377.2021.05.028]
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肺结核348例耐药情况调查及影响因素分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年5期
页码:
626-629,633
栏目:
调查研究
出版日期:
2021-05-05

文章信息/Info

Title:
Investigation of drug resistance in 348 cases of pulmonary tuberculosis and its influencing factors
作者:
刘 莉; 李 晋; 马 云; 吴 婷; 董 娜; 崔 倍; 张 宁
(陕西省结核病防治院,陕西 西安 710100)
Author(s):
LIU Li; LI Jin; MA Yun; WU Ting; DONG Na; CUI Bei; ZHANG Ning
(The Tuberculosis Prevention and Care Hospital in Shaanxi Province,Xi'an 710100,China)
关键词:
肺结核;  耐药;  影响因素;  结核病接触史;  复治
Keywords:
Pulmonary tuberculosis;  Drug resistance;  Influencing factors;  Contact histoy of lung tuberculosi;  Retreat
分类号:
R 521
DOI:
DOI:10.3969/j.issn.1000-7377.2021.05.028
文献标志码:
A
摘要:
目的:调查348例肺结核患者的耐药情况及影响因素。方法:通过对结核菌培养及药敏实验诊断为耐药肺结核(DRT)患者的主要临床特征信息(包括性别、职业、结核病接触史、饮酒、抗结核治疗史、吸烟及有无糖尿病等)进行统计分析。结果:1132例结核病患者中,耐药患者348例,总耐药率30.74%(348/1132),单耐药率8.48%(96/1132); 多耐药率4.77%(54/1132),耐多药率13.16%(149/1132); 准广泛耐药及广泛耐药率4.33%(49/1132),初治病例耐药率为23.98%(229/955),复治病例耐药率为67.23%(119/177)。复治患者耐药率明显高于初治患者(P<0.05),有结核病接触史和复治患者耐药的发生率显著高于无接触史或初治的患者(P<0.05)。结核病接触史和复治是DRT发生的危险因素,OR值分别为4.342(95%CI:2.123～8.877)和6.505(95%CI:4.596～9.205)。结论:本组患者总耐药率低于全国水平,但耐多药率高于全国平均水平,因此,加大结核病宣传,提高治疗依从性,加强医院合理用药、积极提高初治治愈率,减少耐药产生。
Abstract:
Objective:To investigate the drug resistance and influencing factors of 348 patients with pulmonary tuberculosis.Methods:The information on the main clinical characteristics(including gender,occupation,history of exposure to tuberculosis,drinking,history of anti-tuberculosis treatment,smoking,and the presence or absence of diabetes,etc.)of patients diagnosed as drug-resistant pulmonary tuberculosis(DRT)by tuberculosis bacterium culture and drug sensitivity test was statistically analyzed.Results:Among the 1132 patients,348 cases of drug resistance were detected,the total drug resistance rate was 30.74%(348/1132),mono-drug resistance rate was 8.48%(96/1132),poly-drug resistance rate was 4.77%(54/1132),multi-drug resistance rate was 13.16%(149/1132),pre-extensively drug resistance and extensively drug resistance rate was 4.33%(49/1132).The drug resistance rate was 23.98%(229/955)in initial treatment and 67.23%(119/177)in retreatment.On the whole,the drug resistance rate was higher in retreatment than that in initial treatment(P<0.05).The incidence of drug resistance in patients with contact history and retreatment of tuberculosis was significantly higher than that of patients without contact history or initial treatment(P<0.05).Tuberculosis treatment history and tuberculosis exposure history were risk factors for DRT(OR=4.342,6.505,both P<0.05).Conclusion:The total drug resistance rate in our hospital is lower than the national level,but the rate of multi-drug resistance is higher than the national average.Therefore,it is necessary to increase tuberculosis publicity,improve treatment compliance,strengthen rational drug use in hospitals,and actively increase the initial cure rate,so as to reduce the occurrence of drug resistance.

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备注/Memo

备注/Memo:
基金项目:陕西省卫生健康委员会科研基金项目(2018D046)
更新日期/Last Update: 2021-05-06