肺结核患者耐多药结核病的危险因素分析

Analysis of Risk Factors for Multidrug-resistant Tuberculosis in Patients with Pulmonary Tuberculosis

目的 研究肺结核患者结核杆菌耐多药结核病发生的相关危险因素。方法 回顾性选取如皋市疾病预防控制中心于2018年1月—2022年12月收治的875例肺结核患者的病历资料,根据耐多药情况进行分组,将非耐多药患者纳入对照组(845例),耐多药患者纳入观察组(30例),应用单因素和多因素Logistic回归分析耐多药结核病的相关危险因素。结果 单因素分析显示观察组患者中,年龄、有无结核病接触史、治疗史、距首次抗结核治疗时间、有无结核空洞以及治疗过程是否中断与对照组比较,差异有统计学意义(P均<0.05)。多因素分析结果显示,耐多药结核病的独立危险因素为复治、治疗过程中断和有结核空洞,差异有统计学意义(OR=1.791、1.980、1.675,P均<0.05)。结论 肺结核患者于治疗过程中发生耐多药结核病的风险较高,复治、结核空洞以及治疗过程中断等同耐多药结核病的发生有密切关联。

Objective To study the related risk factors of multidrug-resistant tuberculosis in patients with pulmonary tuberculosis.Methods The medical records of 875 patients with pulmonary tuberculosis diagnosed by Rugao Center for Disease Control and Prevention from January 2018 to December 2022 were retrospectively selected.The patients were grouped according to multidrug resistance.The non-multidrug-resistant patients were included in the control group(845 cases),and the multidrug-resistant patients were included in the observation group(30 cases).Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of multidrug-resistant tuberculosis.Results Univariate analysis showed that there were significant differences between the observation group and the con-trol group in age,history of tuberculosis contact,history of treatment,time from the first anti-tuberculosis treatment,presence or absence of tuberculosis cavity,and whether the treatment process was interrupted(all P<0.05).Multivari-ate analysis showed that the independent risk factors of multidrug-resistant tuberculosis were retreatment,treatment interruption and had tuberculosis cavity,and the differences were statistically significant(OR=1.791,1.980,1.675,all P<0.05).Conclusion Patients with pulmonary tuberculosis have a higher risk of multidrug-resistant tuberculosis dur-ing treatment.Retreatment,tuberculosis cavity and interruption of treatment are closely related to the occurrence of multidrug-resistant tuberculosis.