中老年肺结核患者耐药性特点及其相关危险因素调查

Investigation analysis on characteristics and correlated risk factors of drug resistance of pulmonary tuberculosis in middle aged and old patients

目的探讨中老年肺结核患者耐药性特点及其相关危险因素。方法对645例中老年肺结核患者进行回顾性调查,根据药敏性试验结果将其分为耐药组和敏感组,比较2组各因素分布,采用多因素logistic回归法筛选影响肺结核患者耐药性的危险因素。结果中老年肺结核患者耐药性发生率为21.24%(137/645),以多重耐药为主(61.31%);多因素结果显示,影响肺结核患者耐药性的危险因素包括流动人口(OR=2.824)、合并基础疾病(OR=3.473)、复治(OR=4.108)、合并空洞(OR=4.522)、治疗依从性差(OR=2.550)、不合理用药(OR=5.317)等。结论中老年肺结核患者具有较高的耐药性发生率,且以多重耐药为主;应结合以上高危因素,早期采取防治措施,降低肺结核患者耐药性发生率。

Objective To explore the characteristics and correlated risk factors of drug resistance of pulmonary tuberculosis in middle-aged and old patients.Methods Totally 645 middle aged and old patients with pulmonary tuberculosis were carried out a retrospective survey,and these patients were divided into the drug resistance group and the sensitive group according to the result of drug sensitivity test.The differences of different factors were compared between the two groups,and the risk factors of drug resistance of pulmonary tuberculosis were screened by multiple factors logistic regression method.Results The incidence rate of pulmonary tuberculosis in middle aged and old patients was 21.24%(137/645),and mainly in multidrug resistance(61.31%).Multiple factor result showed that the risk factors of drug resistance of pulmonary tuberculosis mainly included floating population(OR=2.824),complicated with underlying diseases(OR=3.473),retreatment(OR=4.108),merged cavity(OR=4.522),bad treatment compliance(OR=2.550)and unreasonable drug use(OR=5.317).Conclusion Middle-aged and elderly patients with pulmonary tuberculosis have a high incidence rate of drug resistance,and mainly in multidrug resistance.The above risk factors should be considered,and the preventive measures should be adopted,to cut down the incidence rate of drug resistance of pulmonary tuberculosis.