大连市耐多药结核危险因素分析

Risk factors for MDR-TB and XDR-TB in Dalian patients

关键词:  结核  耐多药结核  危险因素

Key words:  [Key words]　tuberculosis  MDR/XDR TB  risk factors

摘要:

[摘要]　目的　探索耐多药结核危险因素。　方法　回顾性分析2012年1月1日—2014年1月1日间大连市（市内四区）结核病医院所有同时有痰结核菌涂片及培养结果的患者954例的临床资料。利用临床相关因素比较及单因素危险因素分析，多因素危险因素分析统计耐药结核（MDR-TB）和广泛耐药结核（XDR-TB）的发生情况，致MDR和XDR的高危因素。　结果　初治者中耐多药肺结核MDR为4.69%，广泛耐多药肺结核XDR为0.88%。复治者中MDR为26.57%，XDR为6.27 %。导致MDR/XDR的危险因素包括治疗方案不完整，剂量不足,应用喹诺酮或注射剂，依从性，糖尿病。　结论　治疗不规范，糖尿病是导致耐多药结核发生的重要因素，耐药机制复杂，需进一步探索。

Abstract:

[Abstract] 〖JP2〗Objective　To explore the risk factors for MDR-TB and XDR-TB in Dalian patients. 〖WTHZ〗Methods〖WTBZ〗 We retrospectively analyzed the clinical records of 954 TB Patients with sputum and culture-proven MDR-or XDR-TB, who were registered from January 1, 2012 to January 1, 2014 in the Dalian Tuberculosis Hospital. 〖WTHZ〗Results　 All TB patients were culture-positive for M. tuberculosis complex and had positive sputum-smear microscopy results. Among first-time patients, 4.69% were MDR-TB and 0.88% were XDR-TB. In recurrent patients, MDR-TB and XDR-TB were 26.57% and 6.27 %, respectively. Significant risk factors for MDR/XDR-TB included incomplete treatment regimen, inadequate doses, previous use of a fluoroquinolone and injectable agent, poor compliance, and diabetes.〖WTHZ〗Conclusion〖WTBZ〗 Inadequate initial regimen and diabetes are important risks of drug resistance. The mechanisms of TB drug-resistance are complex and need further studies.