摘要
目的了解乌鲁木齐市耐药肺结核的发生情况及流行病学特征,并分析影响肺结核患者耐药的相关因素。方法调查2012年1月至2015年5月于本院就诊的936例肺结核患者的基本情况,并对所有患者的菌株进行11种体外药敏试验,分析患者耐药肺结核的发生情况及相关因素。结果 936例肺结核患者总耐药率为29.06%,其中初治患者106例,总耐药率为18.00%;复治患者166例,总耐药率为47.84%。总体耐多药110例(11.75%)。272株结核分枝杆菌耐药率顺位前五位依次为异烟肼(29.04%)、链霉素(21.69%)、利福平(18.01%)、氧氟沙星(16.54%)、左氧氟沙星(14.34%),初治患者中链霉素耐药率最高,复治患者中异烟肼耐药率最高。经Logistic回归分析发现,人口性质(流动人口)、登记分类(复治)是肺结核耐药的危险因素,完成全部疗程是肺结核耐药的保护性因素,且差异均具有显著性(P<0.05)。结论乌鲁木齐市耐药肺结核的发生率较高,面临耐多药及广泛耐药肺结核的挑战,同时应重点关注异烟肼、利福平、链霉素一线抗结核药物的使用,并针对耐药肺结核的危险因素采取相应措施。
Objective To understand the prevalence and epidemiological characteristics of drug resistant tuberculosis in Urumqi, and to analyze the related factors of drug resistance. Method Selected 936 patients with pulmonary tuberculosis who were treated in our hospital from January 2012 to May 2015 as the research objects, investigated their basic conditions, analyzed the drug sensitivity test of 11 strains of them, and analyzed the occurrence and related factors of drug resistant tuberculosis. Result Among the 936 patients, the total drug resistance rate was 29.06%, in which 106 patients with newly diagnosed the total drug resistance rate was 18.00%, 166 cases of re-treatment, the total drug resistance rate was 47.84%. Total multi drug resistance in 110 cases(11.75%). The rate of drug resistance was isoniazid(29.04%), streptomycin(21.69%), rifampicin(18.01%), ofloxacin(16.54%), levofloxacin(14.34%)(P〈0.05). The highest drug resistance rate in newly diagnosed patients was streptomycin, isonicotinic acid hydrazide had the highest drug resistance rate in retreatment patients. Logistic regression analysis showed that, nature of the population(floating population), registration classification(re-treatment) were the risk factors for drug resistant tuberculosis, to complete a full course of treatment was the protective factor of drug resistant pulmonary tuberculosis, and the differences were statistically significant(P〈0.05). Conclusion The incidence rate of drug resistant tuberculosis in Urumqi is high, which is faced with the challenge of multi drug resistance and drug resistance, and the use of isoniazid, rifampicin and streptomycin is the same as the risk factors of drug resistant tuberculosis.
出处
《中国医学前沿杂志(电子版)》
2016年第5期91-94,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
耐药
肺结核
流行病学特征
Drug resistance
Pulmonary tuberculosis
Epidemiological characteristics