石家庄市耐多药肺结核相关危险因素分析

Analysis of the risk factors related to multidrug-resistant tuberculosis in Shijiazhuang

目的探讨石家庄市肺结核发生耐药相关危险因素,为耐药肺结核的临床防治提供相关的理论依据。方法收集石家庄市121例肺结核耐药病人和149例非耐药病人的资料(性别、年龄、居住地、初治/复治、中断治疗、首次就诊在非结核病定点机构),对有意义的数据进行分析,发现肺结核耐药的相关危险因素。结果肺结核耐药的发生与病人的性别、年龄比较,差异无统计学意义(χ2=0. 16,3. 69,P> 0. 05),居住地为农村、多次治疗、治疗过程中断、首次就诊在非结核病定点机构,耐药组明显高于非耐药组病人,差异有统计学意义(χ2=22. 16,11. 44,17. 01,6. 23,P <0. 05);多因素非条件Logisitic回归分析显示,居住地为农村(OR=0. 110,95%CI=0. 050～0. 240)、多次治疗(OR=3. 905,95%CI=2. 056～7. 416)、中断治疗(OR=2. 346,95%CI=1. 334～4. 127)、首次就诊在非结核病定点机构(OR=3. 623,95%CI=1. 835～7. 151)是产生耐多药肺结核的危险因素。结论居住地为农村、多次治疗、中断治疗、首次就诊在非结核病定点机构的肺结核病人可能是发生耐多药肺结核病人的危险因素,性别、年龄与耐药肺结核的发生没有明显的相关性。

Objective To investigate the risk factors related to multidrug-resistant tuberculosis( TB) in Shijiazhuang,and to provide relevant theoretical basis for clinical prevention and treatment of drug-resistant pulmonary tuberculosis. Methods The clinical information( gender,age,place of residence,primary/recurrent treatment,the course of treatment being interrupted or not,the first visit to a designated TB medical institution or not) of 121 drug-resistant TB patients( a resistance group) and 149 non-drug resistant TB patients( a nonresistance group) were collected and statistically analyzed in Shijiazhuang. The multivariate non conditional logistic regression analysis was performed to analyze the statistically significant factors to find the related factors of drug resistance of pulmonary TB. Results There was no statistically significant difference in the incidence of tuberculosis drug resistance compared with the patient’s gender and age( χ2= 0. 16,3. 69,P > 0. 05). As to the rural residents,receiving treatments for many times,experiencing interruption of treatment process,and having their first treatment in a non-tuberculosis designated institution,the drug resistance group was significantly higher than the non-drug resistant group. The difference was statistically significant.( χ2= 22. 16,11. 44,17. 01,6. 23,P < 0. 05). Multivariate unconditional Logisitic regression analysis showed that the risk factors for multidrug-resistant tuberculosis include: dwelling in rural areas( OR = 0. 110,95% CI = 0. 050 ~ 0. 240),receiving multiple treatments( OR = 3. 905,95% CI = 2. 056 ~ 7. 416),experiencing interruption of treatment( OR = 2. 346,95% CI = 1. 334 ~ 4. 127),and having the first treatment in a non-tuberculosis fixed-point institutions( OR = 3. 623,95% CI = 1. 835 ~ 7. 151). Conclusion The risk factors for multidrug-resistant tuberculosis include: dwelling in rural areas,receiving multiple treatment,experiencing interruption of treatment,and having the first treatment in a non-tuberculosis fixed-point institutions. There was no significant correlation between gender and age in the development of drug-resistant tuberculosis..