摘要
目的 分析利福平(RIF)耐药结核病患病率和危险因素。方法 以2015年1月至2019年12月在青海省第四人民医院登记为涂阳的结核病患者为研究对象,进行细菌检测和药敏试验(异烟肼、链霉素、RIF、乙胺丁醇)。结果 115例(10.24%)分离株至少对RIF耐药(RR-TB),91例(79.13%)为耐多药(MDR-TB),17株(14.78%)为单耐RIF(RMR-TB),7株(6.09%)对四种药都耐。男性(校正后OR=1.33,95%CI:1.02~3.15,P<0.001)、结核病接触史(校正后OR=4.20,95%CI:2.35~6.35,P<0.001)、慢性阻塞性肺疾病(COPD,校正后OR=2.31,95%CI:1.21~5.32,P=0.036)为新发RR-TB相关因素。结核病接触史(校正后OR=3.92,95%CI:1.59~7.63,P=0.015)、COPD(校正后OR=1.75,95%CI:1.05~4.22,P=0.025)和第一次结核病发作时抗结核药治疗的持续时间≥6个月(校正后OR=1.56,95%CI:1.12~3.85,P<0.001)为既往RR-TB相关因素。结论 RR-TB发病率较高,尤其是MDR-TB,详细的药物测试对于MDR-TB治疗的评估至关重要。男性、结核病接触史、COPD、第一次结核病发作时抗结核药治疗持续时间≥6个月是RR-TB的危险因素。
Objective To analyze the prevalence and risk factors of rifampicin(RIF)drug-resistant tuberculosis.Methods Tuberculosis patients who were registered as the smear-positive from January 2015 to December 2019 in the Fourth People′s Hospital of Qinghai Province were selected as subjects for bacterial detection and drug sensitivity test(isoniazid,streptomycin,RIF,ethambutol).Results A total of 115 isolates(10.24%)were resistant to at least RIF(RR-TB);91 isolates(79.13%)were resistant to multiple drugs(MDR-TB);17 isolates(14.78%)were resistant to single RIF(RMR-TB);and 7 isolates(6.09%)were resistant to all four drugs.Male(adjusted OR=1.33,95%CI:1.02-3.15,P<0.001),history of tuberculosis exposure(adjusted OR=4.20,95%CI:2.35-6.35,P<0.001),and chronic obstructive pulmonary disease(COPD,adjusted OR=2.31,95%CI:1.21-5.32,P=0.036)were the new RR-TB related factors.History of tuberculosis exposure(adjusted OR=3.92,95%CI:1.59-7.63,P=0.015),COPD(adjusted OR=1.75,95%CI:1.05-4.22,P=0.025)and≥6 months of duration of anti-TB drug treatment at the time of first TB attack(adjusted OR=1.56,95%CI:1.12-3.85,P<0.001)were associated with prior RR-TB.Conclusion RR-TB has a high incidence,especially MDR-TB,and detailed drug testing is essential for the evaluation of treatment for MDR-TB.Male,a history of TB exposure,COPD,and≥6 months of duration of anti-TB drug treatment at the time of first TB attack were risk factors for RR-TB.
作者
金兆鑫
宋雪云
JIN Zhaoxin;SONG Xueyun(The Fourth Department of Respiratory,the Fourth People′s Hospital of Qinghai Province,Xi′ning810000,China)
出处
《中国现代医生》
2022年第1期54-57,61,共5页
China Modern Doctor
关键词
结核病
结核分枝杆菌
利福平
耐多药
危险因素
Tuberculosis
Mycobacterium tuberculosis
Rifampicin
Multi-drug resistance
Risk factor
