宁波地区老年结核病耐药现状及相关因素分析

Drug resistant tuberculosis in the elderly and related factors in Ningbo

目的了解宁波地区老年耐药结核病的流行现状,为结核病的防控提供依据。方法将宁波市2010-2011年结核病耐药监测资料中的老年人口痰培养阳性肺结核病例作为研究对象进行异烟肼(INH)、利福平(RFP)、链霉素(SM)及乙胺丁醇(EMB)4种药物的耐药性测定及菌种鉴定。结果研究共纳入痰培养阳性老年肺结核患者381例。老年肺结核病例中总耐药率及总耐多药率分别为37.0%和9.4%,耐药谱均以耐异烟肼为最高。治疗史、疗程完成情况及户籍情况是老年肺结核耐药的影响因素。结论宁波地区老年肺结核耐药现状较为严重,需进一步加强老年肺结核病的防控工作。

Objective To understand the prevalence of drug resistant tuberculosis （ TB ） in the elderly in Ningbo and provide evidence for the prevention control and treatment of drug-resistant TB. Methods TB case diagnosed in the elderly in Ningbo from 2010 to 2011 were selected as study subjects to conduct drug susceptibility tests of isoniazid, rifampicin, streptomycin and ethambutol. Univariate and multivariate analysis were performed to determine the risk factors associated with the drug resistance. Results A total of 381 TB cases in the elderly were enrolled in the study. The overall drug resistant rate was 37.0% （ 141/381 ）, the multidrug resistant rate was 9.4% （ 36/381 ）. The drug resistant rate to isoniazid was highest. The related factors of drug resistant TB in the elderly included the history of previous TB treatment, uncompleted treatment and residence status. Conclusion The prevalence of drug resistant TB in the elderly was relatively high in Ningbo, suggesting the necessity to strengthen the TB control oro^ram in the elderly.