2012—2019年包头地区肺结核患者抗TBGL与抗LAM抗体的监测分析及风险评估

Monitoring analysis of tuberculosis-related antibodies and risk assessment of tuberculosis in Baotou region,2012-2016

目的探究肺结核相关抗体的监测分析及风险评估。方法收集2012年1月至2019年12月在包头市接受治疗的39605例肺结核患者,进行流行病学调查;对有效血清样本进行临床诊断,同时进行药敏试验,记录患者的阳性率和耐药情况;对所有有效患者影响复发的风险因素进行单因素分析。结果在流行病学调查结果中,年龄、职业和检测方式等方面差异有统计学意义(P<0.05);药敏试验共获得了22703例菌株,其中,耐异烟肼、耐链霉素和多重耐药的发生率分别为19.99%、15.54%、15.19%;在抗体诊断过程中,较之于单一检测法,联合检测法的阳性率显著更高,差异有统计学意义(P<0.05);风险因素分析结果发现年龄、停药残留空洞、耐药情况等因素是影响患者病情复发的重要危险因素(P<0.05)。结论2012—2019包头市肺结核的发生率受年龄、职业等因素影响,抗TBGL和抗LAM抗体联合检测具有较高的敏感性和特异性,是肺结核的重要诊断方法。同时,肺结核的复发受多种因素影响,需要患者配合治疗,提高治愈率。

Objective To explore the monitoring analysis of pulmonary tuberculosis related antibodies and conduct and risk assessment of tubercuosis.Methods A total of 39605 patients who were treated in Baotou tuberculosis prevention and treatment center from January 2012 to December 2016 were enrolled for epidemiological investigation.Smear,imaging,tuberculin test,clinical signs and anti-TBGL and anti-LAM antibody tests were used to diagnose the effective serum samples,and drug sensitivity tests were conducted to record the positive rate and drug resistance of the patients.Univariate and multivariate analyses were performed on all the factors influencing the recurrence of the patients including the gender,age,marriage,nutritional status,initial lesion range,regular treatment,drug withdrawal residual cavity,drug resistance,treatment style,course of treatment,and comorbidities.Results There were significant differences in epidemiological survey results in age,occupation and detection methods(P<0.05).A total of 22703 strains were obtained in the drug sensitivity test,19.99%of which were isoniazid resistance,15.54%were streptomycin resistance,and 15.19%were multi-drug resistance.In the process of antibody diagnosis,the positive rate of the parallel test was significantly higher than that of the single test and the series test,with a statistically significant difference(P<0.05).The results of risk factor analysis showed that age,drug withdrawal residual cavity,and drug resistance were important risk factors influencing the recurrence of the patients(P<0.05).Conclusion The incidence rate of tuberculosis in Baotou from 2012 to 2016 was affected by age,occupation and other factors.It is of great significance to develop diagnostic methods with higher sensitivity.The parallel detection of anti-TBGL and anti-LAM antibodies had high sensitivity and specificity,which is an important diagnostic method for tuberculosis with high application value.At the same time,the recurrence of tuberculosis is affected by many factors,which requires patients to be cooperative with treatment in order to improve the cure rate.