湖南邵阳市2014--2015年肺结核耐药的危险因素

Risk factors of patients with drug resistant tuberculosis in Shaoyang,Hunan,2014-2015

目的探索湖南邵阳市肺结核发生耐药的危险因素,为制定耐药肺结核的防控措施提供科学依据。方法采用1∶1配对病例对照研究方法,病例组为邵阳市2014年1月1日—2015年12月31日发生的耐药肺结核患者,对照组为同期非耐药肺结核患者,按性别、年龄(±5岁)1∶1个体匹配。病例组和对照组使用统一的调查问卷开展面对面调查。结果本次调查耐药和非耐药肺结核患者各64例,单因素分析结果显示肺结核发生耐药的危险因素:首次治疗过程出现药物不良反应、既往治疗过程中出现药物不良反应、首次治疗未在结防机构、首次治疗使用自费药、首次治疗未满疗程、首治期间中断治疗;多因素条件Logistic回归分析结果显示首次治疗未完成疗程(OR=7.26,95%CI:1.36~38.87)、首治期间中断治疗(OR=5.13,95%CI:1.08~24.41)是肺结核发生耐药的危险因素。结论首次治疗未完成疗程和首次治疗期间中断治疗是邵阳市肺结核耐药的危险因素,治疗期间应强调全程和规范治疗,减少耐药结核的发生。

Objective To master the resistance risk factors which cause the drug resistance in Shaoyang Municipal,inorder to control drug-resistant TB control behavior and to provide scientific evidence for intervention measures. Methods Byadopting the method of 1：1 matched case-control study,patients with drug-resistant TB in Shaoyang Municipal on January 1,2014 to December 31,2015 were selected as case group,during the same period of non-drug-resistant tuberculosis patients ascontrol group. Case group and the control group individual were 1：1 matched by sex and age（± 5 years）,using a unifiedquestionnaire survey face to face. Results The survey of 64 pairs of cases patients with single factor analysis showed that therisk of drug-resistant tuberculosis factors were： Adverse drug reactions in the process of treatment for the first time,adversedrug reactions in the process of treatment,treatment for the first time in which institutions,treatment for the first time to usemedicine at one＇s own expense,treatment un-complete for the first time,treatment interruption for the first time. Multifactorconditional logistic regression analysis results showed that the treatment of unfinished course for the first time（OR=7.26,95% CI：1.36-38.87）,the first treatment interruption（OR=5.13,95% CI：1.08-24.41） were the risk of drug-resistanttuberculosis. Conclusion Treatment of unfinished course for the first time and for the first time during interrupt aretuberculosis treatment resistant risk factors in Shaoyang,treatment should be emphasized during treatment and all thespecification,reduce the occurrence of drug-resistant tuberculosis.