连云港市耐利福平结核病人主要危险因素及经济负担

Study of risk factors and economic burden for rifampin resistant tuberculosis patients in Lianyungang city

目的了解连云港市耐利福平结核病发生的危险因素及患者的经济负担,为采取针对性预防措施提供依据。方法选取近3年来全市所有耐利福平结核病患者119例(利福平耐药组),并相应选取利福平敏感结核患者237例(利福平敏感组),采用自行设计的耐药结核病人危险因素及疾病负担调查表,进行回顾性问卷调查。结果利福平耐药组平均年龄[(46.95±16.58)岁]低于利福平敏感组[(51.88±18.65)岁](P<0.05);单因素分析结果显示,是否有过结核病相似症状、做过胸片及痰标本检查、过去是否患有结核病、有无督导服药、首次和最近1次治疗医疗机构类型、最近1次治疗结果、抗结核治疗用药时间、涂阳病人最终结果等因素,两组间差异均有统计学意义(P值均<0.05)。多因素分析结果,年龄越大、最近1次治疗效果好、抗结核病治疗时间长、初治者,耐药发生率较低(P值均<0.05)。利福平耐药组门诊、住院等各项花费和因病休工休学天数均高于利福平敏感组(P值均<0.05)。结论应制定行之有效的防控对策,减少耐药结核的发生,减轻患者疾病负担。

Objective To investigate the risk factors and economic burdens for rifampin(RFP)drug-resistant TB patients in Lianyungang city;to provide evidence for making preventive measures.Methods A total of 119RFP-resistant tuberculosis patients(RFP-resistant group)and 237 RFP sensitive patients(RFP sensitive group)diagnosed in recent 3years were selected for retrospective investigation on risk factors and disease burdens using self-designed questionnaires.Results The average age of RFP-resistant group[(46.95±16.58)years old]was lower than RFP sensitive group[(51.88±18.65)years old](P<0.05).Univariate analysis showed that similar symptoms of tuberculosis,whether examined by chest X-ray or sputum smear,whether suffering from tuberculosis in the past,medication supervision,primary and recent medical institutions types,last treatment outcome,anti-tuberculosis treatment duration and the final treatment outcome of smear-positive patients were significant factors(all P<0.05).Multivariate analysis showed patients who were older,having better outcome of last treatment or longer duration of anti-TB treatment,or taking initial treatment had lower drug resistant rates.RFP-resistant group had more cost and days taking off by TB than RFP sensitive group(all P<0.05).Conclusion Effective prevention and control measures should be developed to reduce DR-TB occurrence and economic burdens of patients.