肺结核合并糖尿病耐多药病例危险因素的1∶1配对病例对照研究

A 1∶1 matched cases-control study on risk factors of multi-drug resistant patient of pulmonary tuberculosis combined with type 2 diabetes

目的探讨肺结核合并糖尿病发生耐多药的危险因素,为肺结核合并糖尿病的耐药防治工作策略制定提供科学依据。方法采用1∶1配对的病例对照研究,纳入54例肺结核合并糖尿病耐多药病例作为病例组,54例肺结核合并糖尿病非耐多药病例作为对照组,对患者基本情况、既往肺结核治疗史、糖尿病治疗相关情况进行问卷调查,将数据用EpiData3.0软件进行录入,运用SPSS18.0统计软件进行条件Logistic回归分析。结果单因素条件Logistic回归分析发现BMI值<18.5(OR=4.000,P=0.002)、糖尿病病程≥5年(OR=65.289,P=0.001)、有糖尿病并发症(OR=65.289,P=0.002)和曾有因糖尿病住院史(OR=6.500,P≤0.001)4个因素在两组病例间分布存在差异。多因素条件Logistic回归分析发现,糖尿病病程≥5年是发生耐多药的危险因素(OR=19.469,P=0.015)。结论肺结核合并糖尿病发生耐多药肺结核与糖尿病病程有关,重点监测糖尿病病程较长的肺结核合并糖尿病病例耐药情况。

Objective To explore risk factors of induced multi-drug resistance in patients of pulmonary tuberculosis combined with type 2 diabetes,and we provide scientific basis for the prevention and control of drug resistance of TB-DM cases.Methods A 1∶1 matched case-control study was used,including 54 cases of pulmonary tuberculosis combined with diabetes multidrug resistance as the cases group,54 cases of pulmonary tuberculosis combined with diabetes non-multidrugresistant cases as the control group.Questionnaire survey was conducted to investigate the basic situation of patients,past treatment history of pulmonary tuberculosis,diabetes treatment-related situation.We used EpiData 3.0 for data entry and SPSS18.0 for statistical Logistic analysis.Results Univariate Logistic analysis showed that following factors were distributed differently between two groups:BMI under 18.5(OR=4.000,P=0.002),diabetes lasts for 5 years or more(OR=65.289,P=0.001),complications of diabetes(OR=65.289,P=0.002),history of hospitalization for diabetes(OR=6.500,P≤0.001).Multivariate conditional Logistic regression analysis found that the course of diabetes over 5 years was a risk factor for multidrug resistance(OR=19.469,P=0.015).Conclusion Multidrug resistant pulmonary tuberculosis with diabetes is associated with the course of diabetes.We should focus on the drug resistance of pulmonary tuberculosis complicated with diabetes with longer course of diabetes.