复治肺结核合并糖尿病患者抗结核药物耐药分析

Analysis on anti tuberculosis drug resistance among retreated pulmonary tuberculosis patients with diabetes

目的了解复治肺结核合并糖尿病患者耐药状况,为临床防治提供依据。方法收集2012年3月至2014年1月山东省胸科医院收住院复治肺结核患者207例,对其进行抗结核药物耐药检测并分析结果,应用SPSS 16.0进行数据统计,两组差异性比较采用χ2检验,以P〈0.05为差异有统计学意义。结果复治肺结核合并糖尿病患者总耐药率66.00%,高于单纯复治肺结核患者耐药率62.42%,两组之间差异无统计学意义（χ2=0.21,P=0.39）;复治肺结核合并糖尿病患者血糖大于14.0 mmol/L组耐药率最高为77.78%,血糖小于7.1 mmol/L组耐药率最低为50.00%,其中血糖大于14.0 mmol/L组耐多药率（77.78%）明显高于7.1~14.0 mmol/L组耐多药率（33.33%）,差异有统计学意义（χ2=4.03,P=0.04）。结论复治肺结核合并糖尿病患者总耐药率高于单纯复治肺结核患者耐药率,两组差异无统计学意义。复治肺结核患者空腹血糖越高,耐药率越高。

Objective To analyze anti tuberculosis drug resistance among retreated pulmonary tuberculosis patients with diabetes. Methods Anti tuberculosis drug resistance test was performed among 207 retreated pulmonary tuberculosis inpatients in Shandong Provincial Chest Hospital from March 2012 to January2014.Chi-square test was used for data statistical analysis. Results The drug resistance rate was 66.00%among TB patients with diabetes and 62.42% among patients with only pulmonary tuberculosis,the difference was not significant（χ2=0.21,P=0.39）.The highest resistance rate of 77.78% was found among TB plus diabetes patients with blood glucose level higher than 14.0mmol/L and the lowest was among those with glucose level lower then 7.1mmol/L.Meanwhile,multi-drug resistance rate was much higher among patients with glucose level of more than 14.0mmol/L compared with those whose glucose level was at range of 7.1to14mmol/L（χ2=4.03,P=0.04）. Conclusions There is no significant difference of drug resistance rate between retreated TB patients and patients with diabetes.However,the drug resistance rate increases with elevated fasting blood sugar level.