[1]周 欢.涂阴培阳肺结核患者180例耐药性及相关因素分析[J].陕西医学杂志,2021,50(7):846-849.[doi:DOI:10.3969/j.issn.1000-7377.2021.07.020]
　ZHOU Huan.Drug resistance and related factors in 180 patients with smear-negative and culture-positive tuberculosis[J].,2021,50(7):846-849.[doi:DOI:10.3969/j.issn.1000-7377.2021.07.020]
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涂阴培阳肺结核患者180例耐药性及相关因素分析

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年7期
页码:
846-849
栏目:
临床研究
出版日期:
2021-07-05

文章信息/Info

Title:
Drug resistance and related factors in 180 patients with smear-negative and culture-positive tuberculosis
作者:
周 欢
(陕西省结核病防治院 陕西省第五人民医院,陕西 西安 710100)
Author(s):
ZHOU Huan
(Shaanxi Provincial Tuberculosis Control Hospital,Xi'an 710100,China)
关键词:
涂阴培阳;  肺结核;  耐药;  危险因素;  利福平;  耐多药
Keywords:
Smear-negative and culture-positive;  Tuberculosis;  Drug resistance;  Risk factors;  Rifampicin;  Multidrug resistance
分类号:
R 521
DOI:
DOI:10.3969/j.issn.1000-7377.2021.07.020
文献标志码:
A
摘要:
目的:探究了涂阴培阳肺结核患者180例的耐药性及相关因素。方法: 纳入收治的涂阴培阳肺结核患者180例,分析患者的耐药情况。根据患者是否发生耐药,分为耐药组和对照组。比较两组的临床资料,使用二元Logistic回归分析法分析影响涂阴培阳肺结核患者耐药性发生的危险因素。结果: 180例涂阴培阳肺结核患者中,耐药率22.78%(41/180)。其中,单耐药(MR)8例(4.44%),多耐药(PDR )11例(6.11%),耐多药(MDR )20例(11.11%),广泛耐药(XDR)2例(1.11%)。药敏试验中,耐药率以异烟肼(INH)(17.22%)、利福平(RFP)(13.89%)、链霉素(SM)(11.67%)较高,丙硫异烟胺(PTO)的耐药率(0.56%)最低。初治患者的耐药率明显低于复治患者,两组比较差异具有统计学意义(均P<0.05)。耐药组流动人口、空洞、复治、吸烟史的发生率明显高于对照组(均P<0.05)。流动人口、空洞、复治、吸烟史均为涂阴培阳肺结核患者耐药性发生的危险因素(P<0.05)。结论:涂阴培阳肺结核患者的耐药率为22.78%,临床中应加强对涂阴培阳肺结核患者的耐药监测,尤其是对于流动人口、复治、吸烟和空洞等高危群体,以提高对涂阴培阳肺结核患者的治疗有效率。
Abstract:
Objective:To explore the drug resistance and related factors in 180 patients with smear-negative and culture-positive tuberculosis were analyzed.Methods:A total of 180 patients with smear-negative and culture-positive tuberculosis were included,and the drug resistance of the patients was analyzed.According to whether the patients developed resistance,they were divided into resistance group and control group.The clinical data of the two groups were compared,and the binary Logistic regression analysis was used to analyze the risk factors affecting the occurrence of drug resistance in patients with smear-negative and culture-positive tuberculosis.Results:Among 180 patients with smear-negative and culture-positive tuberculosis,the drug resistance rate was 22.78%(41/180).Among them,8 cases were monoresistance(4.44%),11 cases were pandrug-resistance(6.11%),20 cases were multidrug resistance(11.11%),and 2 cases were extensively drug-resistance(1.11%).In the drug susceptibility test,the resistance rate of isoniazid(INH),rifampicin(RFP),streptomycin(SM)and prothiazide(PTO)were 17.22%,13.89%,11.67%,0.56% in turn.The drug resistance rate of newly treated patients was significantly lower than that of retreated patients(P<0.05).The incidence of floating population,cavitation,retreatment,and smoking history in the resistance group was significantly higher than those in the control group(all P<0.05).Floating population,cavities,retreatment,and smoking history were all risk factors for drug resistance in patients with smear-negative and culture-positive tuberculosis(all P<0.05).Conclusion:The drug resistance rate of smear-negative and culture-positive tuberculosis patients is 22.78%.In clinical practice,the monitoring of drug resistance of smear-negative and culture-positive tuberculosis patients should be strengthened,especially for high-risk groups such as floating population,retreatment,smoking and cavitation,in order to improve the treatment efficiency of smear-negative and culture-positive tuberculosis.

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备注/Memo

备注/Memo:
基金项目:国家“十三五”科技重大专项(2018ZX10722-301-003-001)
更新日期/Last Update: 2021-07-05