湖南湘潭县农村居民耐多药结核病危险因素病例对照研究

A case-control study on risk factors of rural patients with multi-drug resistant tuberculosis in Xiangtan,Hunan

目的探讨湘潭县农村居民耐多药结核病患病的危险因素,为农村耐多药结核病防治提供依据。方法采用1∶1配对病例对照研究方法,在湘潭县"结核病信息管理系统"中抽取耐多药结核病与非耐多药结核病(泛耐药患者除外)的农村居民患者各76名进行入户问卷调查,采用条件logistic回归分析耐多药结核病患病的危险因素。结果单因素分析显示,患者家庭总收入低、低体重(BMI<18.5)、文化水平低、结核病接触史、既往不规则结核病治疗史、复治等方面的差异有统计学意义(P<0.05);多因素条件logistic回归分析显示,家庭总收入低、结核病接触史、既往不规则结核病治疗史是结核病患者产生耐多药的主要危险因素OR及95%CI分别为1.667(1.105~2.391)、3.471(2.230~5.314)、4.836(3.119~7.538)。结论需采取针对性的措施提高结核病患者治疗依从性,并对家庭困难的结核病患者提供更多的政策支持。

Objective To investigate the risk factors of rural patients with multi-drug resistant tuberculosis（MDR-TB）in Xiangtan County,so as to provide the evidence for MDR-TB control and prevention. Methods A 1∶1 matched case-control study was conducted,in which there were 76 MDR-TB patients in a case group and 76 TB patients other than MDR-TBin a control group. All of the TB patients came from＂TB Management Information System＂. A questionnaire survey of TBpatients was performed,and a conditional logistic regression analysis was used for data analysis. Results The univariateanalysis showed that there were significant differences between the two groups in family income,low weight（BMI18.5）educational level,tuberculosis contact history,irregular treatment of tuberculosis,diabetes history and retreatment oftuberculosis（P〈0.05）. The multivariate logistic regression analysis indicated that the low level of family income（OR=1.667,95%CI=1.105-2.391）,tuberculosis contact history（OR=3.471,95%CI=2.230-5.314） and irregular treatment of tuberculosis（OR=4.836,95%CI=3.119-7.538） were the main risk factors. Conclusion The targeted measures should be taken to improvetreatment compliance of TB patients,and the authority should take more supports for poorpatients.