目的分析耐多药肺结核患者耐药性产生的危险因素。方法收集涂阳肺结核患者823例的痰标本进行罗氏培养及药敏试验,根据药敏结果将至少同时对利福平及异烟肼耐药患者作为耐多药组(105例),其余患者为对照组(718例),分析耐多药形成原因。结果单因素分析显示,耐多药组和对照组性别构成比、家庭收入、BMI、接受化疗及不正规治疗情况比较差异有统计学意义(P<0.05)。多因素分析显示,复治、家庭收入偏低、接受不正规治疗为肺结核患者耐多药产生的危险因素(P<0.05)。结论需重视结核病患者的健康教育和经济救助,加强对有传染性的耐多药结核患者的隔离管理。 Objective To analyze the risk factors of resistance in multi-drug resistant pulmonary tuberculosis patients. Methods A total of 823 sputum smear positive smear positive pulmonary tuberculosis patients were collected for Roche culture and drug susceptibility testing. According to the results of susceptibility testing, at least two groups of patients resistant to rifampicin and isoniazid were used as multidrug resistance group (105 cases), and the rest were Control group (718 cases), analysis of multidrug-resistant causes. Results Univariate analysis showed that there were significant differences in sex composition ratio, family income, BMI, chemotherapy and irregular treatment in the multi-drug resistant group and the control group (P <0.05). Multivariate analysis showed that retreatment, low family income, and irregular treatment were the risk factors for MDR in patients with pulmonary tuberculosis (P <0.05). Conclusion It is necessary to pay attention to the health education and economic aid for TB patients and to strengthen the isolation management of patients with infectious MDR-TB.