2014-2015年顺德地区耐药与非耐药肺结核患者的流行病学特征分析

Epidemiological characteristics of patients with drug-resistant and non-drug-resistant tuberculosis in Shunde region,2014-2015

目的分析顺德地区耐药与非耐药肺结核患者的流行病学特征。方法对顺德地区2014年1月-2015年10月符合条件的所有涂阳肺结核706例患者进行问卷调查,包括诊断情况、患者基本信息、本次就诊情况及既往史等逐一进行问卷调查分析,数据录入Excel表格,进行统计学分析。结果在706例研究对象中,肺结核总耐药率为30.88%(218)。在收回的合格问卷700份中,非耐药组483份,耐药组217份。耐药组与非耐药组间的文化程度、就诊是否延迟和合并慢性病情况差异有统计学意义(P<0.05)。耐药组复治患者比例(26.3%)、病变累及肺野≥3个的患者比例(52.5%)、肺部有空洞形成的患者比例(30.4%)均高于非耐药组,而耐药组的首次抗结核治疗完成疗程者比例(65.4%)低于非耐药组(91.9%),差异均有统计学意义(P<0.05)。结论 2014-2015年顺德地区肺结核患者的复治率及耐药率较高,加强本地区、尤其是文化程度较低人群的结核病防治知识的宣传力度,让肺结核患者及时就诊,提高首次抗结核治疗完成率,减少复治患者数量,是减少耐药肺结核发生的关键。

Objective To analyze the epidemiological features of patients with drug-resistant and non-drug-resistant tuberculosis in Shunde region. Methods Questionnaire survey on the diagnosis,patients＇ general information,the present and the past medical records was conducted among 706 patients with smear-positive pulmonary tuberculosis in Shunde region from January2014 to October 2015. The data were entered into the Excel,and then statistically analyzed. Results Among 706 research subjects,the total drug resistance of pulmonary tuberculosis was 30. 88%（ 218 / 706）. 700 qualified questionnaires were retrieved,including 483 cases of non-drug-resistant tuberculosis and 217 cases of drug-resistant tuberculosis. There were statistically significant differences in the educational background,postponing visiting doctor and complicating with chronic diseases between drug-resistant tuberculosis group and non-drug-resistant tuberculosis（ P〈 0. 05）. The proportion of re- treated patients（ 26. 3%）,the proportion of patients with lesions involving the lung field ≥ 3（ 52. 5%） and the proportion of patients with intrapulmonary cavity（ 30. 4%） in drug-resistant group were all higher than those of non-drug-resistant group,while the proportion of patients completing the first course of anti- TB treatment in drug- resistant group was lower than that of non- drug- resistant group（ 65. 4% vs.91. 9%）,and the differences were statistically significant（ both P〈0. 05）. Conclusions The re-treatment rate and the drug resistance rate of pulmonary tuberculosis patients in Shunde region are high. The key points to reduce the occurrence of drug-resistant tuberculosis are to enhance the propaganda about TB prevention and treatment in local region,especially in the group with poor educational background,to let the TB patients timely visit the doctor,to improve the complete rate of first course of anti-TB treatment and to reduce the number of re-treatment patients.