川南地区136例利福平耐药患者预后分析

Prognostic Analysis of 136 Patients with Rifampicin Resistance in Southern Sichuan

目的分析川南地区利福平耐药患者临床特点及预后,为本地区耐药结核病防治提供科学依据。方法收集2018年8月至2021年12月期间在我院就诊有药敏试验结果的利福平耐药结核病患者136例,采集人口学特征及临床资料,分析利福平耐药患者临床特点及预后。通过χ^(2)检验和Logistic回归等方法分析影响利福平耐药结核病预后的影响因素。结果Logistic回归分析提示在利福平耐药结核中,复治(P=0.031,OR=2.512)、空洞(P=0.008,OR=3.373)、COPD(P=0.014,OR=4.436)对预后存在显著性影响;在耐多药结核、准广泛耐药、广泛耐药中,空洞(P=0.006,OR=3.809)、COPD(P=0.008,OR=4.920)是利福平耐药结核治疗失败的危险因素。结论川南地区利福平耐药肺结核发病率较高,治疗成功率偏低;利福平耐药结核治疗失败的危险因素包括复治、空洞、COPD,应加强对利福平耐药患者的监测并尽量予以指南推荐新药治疗。

Objective To analyze clinical characteristics and prognosis of patients with rifampicin resistance in southern Sichuan,and to provide scientific basis for the prevention and treatment of drug-resistant tuberculosis in this area.Methods From August 2018 to December 2021,136 cases of tuberculosis patients with drug sensitivity test results in our hospital were collected,anddemographic characteristics and clinical data were collected to analyze clinical characteristics and prognosis of patients with rifampicin resistance.Chi-square test and Logistic regression were used to analyze the influencing factors on the prognosis of rifampicin-resistant tuberculosis.Results Logistic regression analysis showed that retreatment(P=0.031,OR=2.512),cavity(P=0.008,OR=3.373)and COPD(P=0.014,OR=4.436)had significant effects on the prognosis of rifampin-resistant tuberculosis.Cavity(P=0.006,OR=3.809)and COPD(P=0.008,OR=4.920)were risk factors for treatment failure of rifampicin-resistant tuberculosis.Conclusion The incidence of rifampin-resistant pulmonary tuberculosis in southern Sichuan is high and the success rate of treatment is low.The risk factors of treatment failure of rifampin-resistant tuberculosis include retreatment,cavitation and COPD.We should strengthen the monitoring of rifampin-resistant patients and try our best to guide and recommend new drugs for treatment.