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目的分析影响博州肺结核患者结核菌耐药的危险因素,为当地结核病的防治提供科学依据。方法对2013年3月1日-2014年2月28日在本州三县市(博乐市、精河县、温泉县)结核病门诊或定点医院相关科室门诊或住院的2339例疑似肺结核病患者行痰涂片,对培养出来有效阳性的187例病人进行抗结核药物敏感性试验,并记录分析患者的年龄、性别、民族、职业与耐药的相关性。结果复治病人(耐药率43.75%)比初治病人(耐药率12.28%)结核菌耐多药的发生风险增加,差异有统计学意义(χ2=11.38,P<0.05);且耐药率在女性、年龄段为35-44岁、汉族及医务工作者中最高,分别为27.78%、30.30%、32.81%、50.00%。结论博州结核杆菌耐药的因素与患者治疗史相关,与性别、年龄、民族及职业可能有关,因此要加强初治结核病人的管理,同时对耐药率高的人群进行重点防治,以减少结核菌耐药率。
Objective To analyze the risk factors of M. tuberculosis resistance in Bozhou tuberculosis patients and provide a scientific basis for the prevention and treatment of local tuberculosis. Methods A total of 2339 cases of suspected pulmonary tuberculosis patients from outpatients or hospitalized in TB clinics or designated hospitals in three counties (Bole, Jinghe, Wenquan) of Honshu from March 1, 2013 to February 28, 2014 Sputum smear, positive and effective culture out of 187 cases of anti-TB drug sensitivity test, and record the patient’s age, gender, ethnicity, occupation and drug resistance. Results The rate of multidrug-resistant MDR was higher in retreatment patients (43.75% vs 12.28%, χ2 = 11.38, P <0.05); and The rate of resistance in women, aged 35-44 years old, the highest among Han and medical workers, were 27.78%, 30.30%, 32.81%, 50.00%. Conclusion The factors of M. tuberculosis resistance in Bozhou are related to the history of patient treatment and may be related to gender, age, ethnicity and occupation. Therefore, we should strengthen the management of newly diagnosed tuberculosis patients and focus on the prevention and control of TB drug-resistant people in order to reduce Mycobacterium tuberculosis resistance rate.