结核病与肺部健康杂志 ›› 2012, Vol. 1 ›› Issue (2): 113-117.

• 论著 • 上一篇    下一篇

四川省自贡市2010—2011年耐药结核病社会人口学和临床影响因素研究

宁柱,邓建平,李群,周世熙,陈曦   

  1. 643000 四川省自贡市疾病预防控制中心结核病防治所
  • 收稿日期:2012-06-17 出版日期:2012-10-20 发布日期:2012-10-20
  • 通信作者: 宁柱,Email:nzh200311@163.com
  • 基金资助:
    四川省卫生厅科研项目(100600);四川省自贡市重点科技计划项目(10504)

Socio-demographic and clinical characteristics of drug resistant tuberculosis during 2010—2011 in Zigong, Sichuan province

NING Zhu,DENG Jian-ping,LI Qun,ZHOU Shi-xi,CHEN Xi   

  1. Zigong City Center for Disease Control and Prevention, Zigong 643000,China
  • Received:2012-06-17 Online:2012-10-20 Published:2012-10-20
  • Contact: NING Zhu,Email:nzh200311@163.com

摘要: 目的 了解四川省自贡市耐药结核病流行现况,并分析影响耐药结核病流行的社会人口学和临床方面的危险因素,为制订和完善结核病防控措施提供依据。方法 以四川省自贡市6个区县结核病防治所2010年4月至2011年8月登记的235例初治和复治结核病患者为研究对象,纳入合格对象232例,耐药47例(20.3%),其中包括耐多药25例(10.8%),采用结构问卷对研究对象的社会人口学和临床方面信息进行调查;通过χ2检验和logistic多元回归等方法分析与耐药结核病相关的影响因素。结果 对232例合格对象进行了耐药相关社会人口学和临床方面影响因素分析,结果发现女性耐多药率为21.4%(9/42),男性耐药率为8.4%(16/190),二者相比差异有统计学意义(OR=2.72;95%CI=1.062~6.957);年收入<4200元人民币的患者发生耐多药率为35.1%(33/94),而年收入>4200元的患者为10.0%(13/130),两者相比差异也有统计学意义(OR=4.87;95%CI=2.278~10.784);同时复治患者发生耐多药的风险要明显高于初治患者(30.8%和6.7%;OR=7.86;95%CI=2.674~23.121)。另外在复治结核患者中,既往治疗次数超过1次的患者发生耐多药的可能性也要明显高于既往治疗次数为1次的患者(46.2%和23.1%;χ2=9.39;P=0.009)。结论 女性、复治患者(尤其是既往治疗多次)及低收入人群是今后耐药结核病,尤其是耐多药结核病防治工作的重点。

Abstract: Objective To describe the drug resistant profile among the diagnosed tuberculosis cases, identify the risk factors in terms of their socio-demographic and clinical characteristics in Zigong city, Sichuan province and to provide the knowledge evidence for anti-TB strategies.Methods The subjects of the study were all the diagnosed TB patients registered in 6 districts of Zigong city within one year between 2010 and 2011, including 235 patients with new cases and retreatment cases. Of 232 eligible cases enrolled within the study period, 25 were resistant to at least one of 4 drugs (isoniazid, rifampicin, ethambutol, streptomycin) and 25 were simultaneously resistant to INH and RFP or referred to multidrug-resistant tuberculosis (MDR-TB). The Questionnaire interview was conducted by the trained interviewers to acquire the subjects’ socio-demographic and clinical information.Results Among 232 eligible subjects analyzed the socio-economic and clinical factors, MDR-TB was observed in 21.4% (9/42) female patients and 8.4% (16/190) male patients(OR=2.72; 95%CI=1.062-6.957). The population with an-nual income less than 4200 RMB had the significantly high proportion of MDR-TB compared to those with annual income more than 4200 RMB (35.1% vs 10.0%; OR=4.87; 95%CI=2.278-10.784). The previously treated patients were in higher risk of developing MDR than newly treated patients. Moreover, among the previously treated patients, the patient with previous treatment more than once were more likely to develop MDR-TB than the patients with previous treatment once (46.2% vs 23.1%; χ2=9.39, P=0.009).Conclusion Female, previously treated TB patients and those with low income were at a higher risk of developing MDR-TB and it should be concerned as the emphasis for the anti-MDR-TB activities in Zigong, Sichuan province.