1∶2个体匹配青年肺结核患者耐多药临床危险因素分析

A 1∶ 2 pair-matched study on risk factors of multi-drug resistance in young tuberculosis patients

目的探讨青年肺结核患者耐多药临床危险因素,为耐多药早期预防提供临床依据。方法采用1∶2个体匹配病例对照研究,随机抽取2014-03~2016-03于徐州市传染病医院就诊的年龄≤40岁青年肺结核患者耐多药患者60例,同时筛选同期就诊单纯青年肺结核患者120例,收集两组患者临床资料,进行危险因素统计分析。结果单因素Logistic回归分析结果显示吸烟、空洞、病程、居住地、治疗中断、联合用药、高脂血症、支气管扩张、营养不良、药物不良反应、Hb A1c升高与青年肺结核患者耐多药发生相关（P〈0.05）。多因素分析结果显示存在空洞（OR=2.539,P=0.003）、存在营养不良（OR=2.751,P=0.013）、Hb A1c值升高（OR=3.254,P=0.003）是青年肺结核患者耐多药发生的危险因素,而居住地为城市（OR=0.299,P=0.022）是青年耐多药发生的保护因素。结论青年肺结核患者发生耐多药现象是由多种因素共同所致,根据不同的危险因素临床上应当采取不同有效预防措施。

Objective To explore the risk factors of multi-drug resistance in young tuberculosis patients,and provide clinical evidence for early prevention. Methods A 1∶ 2 pair-matched case control study was conducted in Xuzhou Infectious Hospital from March 2014 to March 2016. A total of 60 young tuberculosis patients with multi-drug resistance,aged≤40 years,were collected,and 120 young patients with only tuberculosis were selected at the same period. The clinical data of all patients were collected and the risk factors were analyzed. Results Univariate Logistic regression analysis showed that several factors increased the risk of multi-drug resistance in young patients with tuberculosis,including smoking,empty,duration,residence,treatment interruption,combination therapy,hyperlipidemia,bronchiectasis,malnutrition,adverse drug reactions and high Hb A1c（ P〈0. 05）. Multivariate analysis results showed that several factors increased the risk of multi-drug resistance in young patients with tuberculosis,including hole（ OR = 2. 539,P = 0. 003）,malnutrition（ OR = 2. 751,P = 0. 013）,high Hb A1 c value（ OR = 3. 254,P = 0. 003）. In addition,living in city（ OR = 0. 299,P = 0. 022） was the protective factors for drug resistance. Conclusion Young tuberculosis patients combined with multi-drug resistance is caused by several risk factors,and the effective preventive measures should be taken according to different clinical risk factors.