平顶山地区某医院195例肺结核患者利福平耐药发生与危险因素分析

Analysis of rifampicin resistance and risk factors in 195 patients with pulmonary tuberculosis in a hospital in Pingdingshan area

目的探究平顶山地区某医院195例肺结核患者利福平耐药发生与危险因素。方法回顾性选取我院2019年8月至2023年4月期间收治的650例阳性肺结核患者作为研究对象,分析患者利福平耐药情况,并根据是否利福平耐药分为对照组(利福平敏感,455例)、观察组(利福平耐药,195例),通过单因素及多因素分析法分析肺结核患者利福平耐药的危险因素。结果650例肺结核患者痰标本中分离出650株结核分枝杆菌,其中有195例利福平耐药患者,利福平耐药率为30.00%。多因素Logistic分析结果显示,有合并症、抗结核治疗次数≥2次、自服药物、未按剂量服药、中断治疗、未知晓肺结核的传播途径为肺结核患者利福平耐药的危险因素(OR=9.767、7.471、5.463、6.693、11.056、10.268,P均<0.05)。结论肺结核患者利福平耐药率为30.00%,有合并症、抗结核治疗次数≥2次、自服药物、未按剂量服药、中断治疗、未知晓肺结核的传播途径为肺结核患者利福平耐药的危险因素,临床可据此给予患者针对性治疗及干预措施,以降低肺结核患者利福平耐药的风险。

Objective To investigate the occurrence and risk factors of rifampicin resistance in 195 patients with pulmonary tuberculosis in a hospital in the Pingdingshan area.Methods 650 patients positive for tuberculosis admitted to the General Hospital of Pingmei Shenma Group from August 2019 to April 2023 were retrospectively selected as the research object.The rifampicin resistance of the patients was analyzed,and the patients were divided into the control group(rifampicin sensitive,455 cases)and the observation group(rifampicin-resistant,195 cases)according to whether they were rifampicin-resistant or not,the risk factors of rifampicin resistance in patients with pulmonary tuberculosis were analyzed by univariate and multivariate analysis.Results A total of 650 Mycobacterium tuberculosis strains were isolated from the sputum samples of 650 patients with pulmonary tuberculosis,among which 195 patients were rifampicin-resistant,and the rifampicin resistance rate was 30.00%.Multivariate Logistic analysis showed that the risk factors of rifampicin resistance in patients with tuberculosis were comorbidities,times of anti-tuberculosis treatment≥2,self-medication,not taking medication according to the dose,interruption of treatment,and not knowing the transmission route of tuberculosis(OR=9.767,7.471,5.463,6.693,11.056,10.268,P<0.05).Conclusion The rifampicin resistance rate of pulmonary tuberculosis patients was 30.00%,the risk factors of rifampicin resistance in patients with pulmonary tuberculosis are comorbidities,the number of anti-tuberculosis treatment≥2 times,self-medication,not taking medication according to the dose,interruption of treatment,and not knowing the transmission route of tuberculosis,Therefore,targeted treatment and intervention measures can be given to patients to reduce the risk of rifampicin resistance in patients with tuberculosis.