摘要
目的:探讨与分析大连地区350例肺结核患者痰培养阳性菌株耐药及治疗失败的原因。方法:选择2016年9月—2019年12月在大连市公共卫生临床中心诊治的耐药肺结核患者350例作为研究对象,所有患者均给予痰培养耐药性检测,判定治疗失败率并进行多因素分析。结果:350例患者的痰培养菌株对异烟肼、利福平、链霉素、乙胺丁醇、左氧氟沙星的耐药率分别为22.3%、26.3%、6.3%、5.4%、7.7%。随访2年,350例患者治疗失败35例,占比10.0%。治疗失败患者的小学文化程度、糖尿病、不规则服药、未全程督导、未系统管理比例与治疗成功患者存在差异(P<0.05)。多变量Logistic回归显示,小学文化程度、糖尿病、不规则服药、未全程督导、未系统管理为导致治疗失败的重要因素(P<0.05)。结论:大连地区耐药肺结核患者治疗失败率低于国家及国际标准,文化程度、糖尿病、不规则服药、未全程督导、未系统管理为重要的影响因素。
Objective:To explore and analysis the reasons for drug resistance and treatment failure of sputum culturepositive strains in 350 cases of pulmonary tuberculosis patients in Dalian area.Methods:From September 2016 to December 2019,350 cases of patients with pulmonary tuberculosis who were diagnosed and treated in Dalian Public Health Clinical Center were selected as the research subjects.All patients were given sputum culture drug resistance testing,and were to determine the treatment failure rate and conduct multivariate analysis.Results:All patients were positive for sputum culture.The resistance rates of sputum culture strains from 350 patients to isoniazid,rifampicin,streptomycin,ethambutol and levofloxacin were 22.3%,26.3%,6.3%,5.4%,7.7%respectively.Two-years followed-up showed that there were 35 patients were failed treatment,accounted for 10.0%.There were significant differences in the proportion of primary school education,diabetes,irregular medication,lack of full supervision,and lack of systematic management compared between patients who failed treatment and those who succeeded in treatment(P<0.05).Multivariate Logistic regression showed that primary school education,diabetes,irregular medication,lack of full supervision,and lack of systematic management were important factors leaded to treatment failure(P<0.05).Conclusion:Treatment failure rate of drug-resistant tuberculosis patients in Dalian is lower than national and international standards.Education level,diabetes,irregular medication,lack of full supervision,and lack of systematic management are important influencing factors.
作者
顾晓峰
蔡春葵
许岩
GU Xiaofeng;CAI Chunkui;XU Yan(Drug Resistance Clinic,Department of Tuberculosis,Dalian Public Health Clinical Center,Dalian 116000,Liaoning,China)
出处
《中国药物滥用防治杂志》
CAS
2022年第9期1221-1224,1234,共5页
Chinese Journal of Drug Abuse Prevention and Treatment
关键词
大连地区
肺结核
痰培养
耐药菌株
治疗失败率
全程督导
规则服药
Dalian area
Pulmonary tuberculosis
Sputum culture
Drug-resistant strains
Treatment failure rate
Wholeprocess supervision
Regular medication
