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目的分析2014年-2016年江西省耐多药结核(MDR-TB)患者的特征及危险因素,为此类患者的防治提供依据。方法收集2014年1月-2016年12月江西省胸科医院2 832例结核患者的信息,同时常规测定一线抗结核药物,对结果进行回顾性分析。结果共计分离到2 823例痰培养阳性患者,其中耐多药结核患者429例。耐多药结核最常见的一线抗结核药物,耐药模式是耐异烟肼和耐利福平,其次是耐异烟肼、利福平和链霉素。治疗失败、年龄、教育程度、农民、长期吸烟、病情严重及痰涂阳患者易出现耐多药结核。Logistic多因素回归分析表明,耐多药结核与治疗失败、老年患者、农民、病情严重及痰涂阳呈正相关(P<0.05)。结论应针对高危人群开展重点普查,及时隔离及治疗患者,减少耐多药结核病的产生及传播。
Objective To analyze the characteristics and risk factors of multidrug-resistant tuberculosis (MDR-TB) in Jiangxi province from 2014 to 2016 and provide the basis for prevention and treatment of such patients. Methods The data of 2 832 tuberculosis patients in Jiangxi Chest Hospital from January 2014 to December 2016 were collected. The first-line anti-TB drugs were routinely measured and the results were retrospectively analyzed. Results A total of 2 823 sputum culture positive patients were isolated, including 429 MDR-TB patients. Multidrug-resistant tuberculosis is the most common first-line anti-TB drugs, drug resistance is resistant to isoniazid and rifampicin, followed by isoniazid, rifampicin and streptomycin. Treatment-failure, age, education level, farmer, long-term smoking, serious illness and sputum smear-positive patients are prone to multidrug-resistant tuberculosis. Logistic multivariate regression analysis showed that MDR-TB was positively associated with failure of treatment, elderly patients, peasants, serious illness and sputum smear positive (P <0.05). Conclusion Key censuses should be conducted in high-risk groups to promptly isolate and treat patients and reduce the generation and spread of multidrug-resistant tuberculosis.