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目的分析深圳市肺结核患者产生耐多药的主要危险因素,为进一步完善深圳市耐多药肺结核(MDR-TB)防控策略提供科学依据。方法采用1∶2配对病例对照研究方法,对2014年1月—2015年12月深圳市慢性病防治中心确诊的178例MDR-TB患者和356例敏感性结核(DS-TB)患者的相关情况进行调查,获取可能导致MDR-TB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回归分析结果显示:30~45岁年龄组(OR=2.704,95%CI=1.239~5.899,P=0.012)、既往有抗结核治疗史(OR=19.815,95%CI=10.411~37.716,P<0.01)、结核空洞(OR=1.701,95%CI=1.101~2.628,P=0.017)和不规律服药(OR=2.063、95%CI=1.035~4.115、P=0.040)发生MDR-TB的风险较高;已婚(OR=0.187、95%CI=0.089~0.392、P<0.01)发生MDR-TB的风险较低。结论 MDR-TB发生的危险因素较为复杂,建议进一步加强早期发现、快速诊断、规范诊疗,强化健康管理、提供心理支持,确保患者接受全程规范治疗,从而降低MDR-TB发生的风险。
Objective To analyze the main risk factors of MDR in patients with pulmonary tuberculosis in Shenzhen and provide scientific basis for further improvement of prevention and control strategies of MDR-TB in Shenzhen. Methods The 1: 2 matched case-control study was conducted to determine the correlation between 178 patients with MDR-TB and 356 patients with sensitive TB (DS-TB) confirmed by Shenzhen Center for Chronic Disease Prevention from January 2014 to December 2015 Investigate and obtain the main risk factors that may lead to MDR-TB, and logistic regression analysis of risk factors. Results The results of multivariate logistic regression analysis showed that there was a history of anti-TB treatment in the 30-45 age group (OR = 2.704, 95% CI = 1.239-5.899, P = 0.012) (OR = 1.701, 95% CI = 1.101-2.628, P = 0.017) and irregular medication (OR = 2.063, 95% CI = 1.035-4.11 5, P = 0.040) The risk of TB was higher; married (OR = 0.187, 95% CI = 0.089-0.392, P <0.01) had a lower risk of developing MDR-TB. Conclusion The risk factors for MDR-TB occurs more complicated, it is recommended to further strengthen early detection, rapid diagnosis, standard treatment, strengthen health management, provide psychological support to ensure that patients receive the full standard treatment, thereby reducing the risk of MDR-TB occurred.