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中国防痨杂志 ›› 2014, Vol. 36 ›› Issue (4): 232-237.doi: 10.3969/j.issn.1000-6621.2014.04.002

• 论著 • 上一篇    下一篇

新疆喀什地区肺结核患者产生耐药的危险因素分析

江道斌 热阳古力·努尔买买提 齐曼古力·吾守尔 胡昕 温澍 肉孜·麦麦提 李双   

  1. 830054 乌鲁木齐,新疆医科大学研究生院2012级科研班(江道斌);新疆医科大学第一附属医院呼吸一科(齐曼古力·吾守尔、胡昕、李双);新疆喀什地区胸科医院 结核病防治所检验科(热阳古力·努尔买买提),医务部(温澍),院长办公室(肉孜·麦麦提)
  • 收稿日期:2013-12-09 出版日期:2014-04-10 发布日期:2014-05-02
  • 通信作者: 齐曼古力·吾守尔 E-mail:qimenw@hotmail.com
  • 基金资助:

    新疆重大疾病医学重点实验室开放课题项目(SKLIB-XJMDR-2012-2)

Analysis on risk factors of drug resistance for pulmonary tuberculosis in Kashgar prefecture of Xinjiang Uygur Autonomous Region

JIANG Dao-bin, Reyangguli  NUERMAIMAITI, Qimanguli WUSHOUER, HU Xin,WEN Shu,Rouzi MAIMAITI, LI Shuang   

  1. Research Class Grade 2012, College of  Postgraduate, Xinjiang Medical University, Urumuqi 830054,China
  • Received:2013-12-09 Online:2014-04-10 Published:2014-05-02
  • Contact: Qimanguli WUSHOUER E-mail:qimenw@hotmail.com

摘要: 目的 分析新疆喀什地区肺结核患者产生耐药的主要危险因素,为预防耐药性结核病的发生提供科学依据。方法 选取2012年10月1日至2013年10月1日新疆喀什地区结核病防治所收住入院的肺结核患者758例, 其中耐药肺结核患者209例。对758例患者进行问卷调查,共获得有效问卷721 份,问卷回收率为95.12%;获取患者可能导致耐药肺结核的主要危险因素,并对其危险因素进行logistic 回归分析。结果 多因素logistic 回归分析结果表明,肺结核患者病程长(OR=10.725,95%CI=5.903~17.326)、DOTS执行不彻底(OR=9.080,95%CI=6.531~17.017)、治疗过程有中断(OR=5.013,95%CI=2.526~9.026)、患者治疗的依从性差(OR=4.683,95%CI=1.935~9.523)、患者合并营养不良(OR=3.959,95%CI=1.984~9.081)、患者合并2型糖尿病(OR=5.002,95%CI=1.993~10.019)及肺结核患者有结核性空洞(OR=2.528,95%CI=1.648~7.001)发生耐药结核病的风险较高。结论 根据上述产生耐药结核病的危险因素,必须有针对性地采取相应的防治措施。

关键词: 结核, 肺, 抗药性, 细菌, 危险因素, Logistic模型, 新疆喀什地区

Abstract: Objective  To analyze the risk factors associated with drug resistance of pulmonary tuberculosis(PTB) patients in Kashgar prefecture of Xinjiang Uygur Autonomous Region, and provide scientific evidence for DR-PTB control.  Methods  A total of 758 PTB patients hospitalized in TB Institute of Kashgar prefecture between 1 October 2012 and 1 October 2013 were recruited in this study, among them, 209 were identified as DR-PTB. Questionnaires were administered to 758 patients, 721 responded with the valid response rate of 95.12%. Logistic regression analysis were used to investigate the risk factors associated with DR-PTB.  Results  The multivariate analysis showed that PTB patients with longer duration of tuberculosis(OR=10.725,95%CI=5.903-17.326),incomplete directly observed treatment(DOTS)(OR=9.080,95%CI=6.531-17.017),poor patient compliance(OR=4.683,95%CI=1.935-9.523),treatment interruption(OR=5.013,95%CI=2.526-9.026), malnutrition(OR=3.959,95%CI=1.984-9.081),T2DM(OR=5.002,95%CI=1.993-10.019) and tuberculous cavity(OR=2.528,95%CI=1.648-7.001)were significantly more likely to have drug resistant PTB.  Conclusion  According to the risk factors of DR-PTB above, we should take effective and targeted prevention measures.

Key words: Tuberculosis, pulmonary, Drug resistance, bacterial, Risk factors, Logistic models, Kashgar Prefecture of Xinjiang