复治病人中影响耐药产生因素的分析

The analysis of causes that result in re-treatment of drug-resistant tuberculosis in Zhejiang

目的研究探讨复治病人耐药与敏感原因的差别,分析造成获得性耐药的危险因素。方法选择15个“WHO结核病耐药监测”县(市)复治耐药与非耐药病人为调查对象,采用流行病学问卷调查法进行相关项目调查。结果耐药与敏感复治肺结核病人在初治诊断治疗单位、初治治疗管理方式构成上无差别;在复治年限、复治原因构成上有差别。复治病人单因素分析中“无管理自服药”、“不规则治疗或中断治疗”是造成复治耐药的主要因素。结论长期复治、化疗管理不善造成的“不规则治疗或中断治疗”都是获得性耐药的危险因素。

Objective To study the different causes that result in re-treatment of drug - resistant and drug - sensitive TB in Zhejiang in order to find the risk factors that result in acquired drug - resistant TB. Method 15 counties were randomly selected from 30 surveillance counties of ＂a global drug - resistance surveillance of TB project of WHO＂. Drug - resistance and drug - sensitive TB cases were intaken continuously in each counties. The method of epidemiological survey with questionnaire was used. Results Between drug - resistance and drug -sensitive TB, there was no significant difference in the proportion of initial treatment unit and management mode. But there was difference in the proportion of re-treatment duration and re-treatment causes. The main reasons of re-treatment were that the patients who treated in general hospital, or did not manage by health workers or irregularly treated. Conclusion The risk factors that result in acquired drug - resistant TB were long - term retreatment and irregularly treated.