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目的了解深圳市结核分枝杆菌耐药情况及耐药产生的影响因素,为制定科学的耐药结核病预防控制策略提供依据。方法以深圳市2008年间新登记的结核分枝杆菌感染的涂阳肺结核病人为研究对象,用比例法进行药物敏感试验获得结核分枝杆菌耐药信息,并通过问卷调查获得患者其他相关信息;单因素分析采用卡方检验、方差分析、Kruskal-Wallis秩和检验,多因素分析采用多分类Logistic回归分析。结果 759例结核分枝杆菌感染的涂阳肺结核患者中,总耐药率为17.52%(133/759),耐多药率为5.14%,单耐药率为9.88%,多耐药率为2.50%。多分类Logistic回归分析显示影响结核分支杆菌耐药性的因素有3个:登记分类、流动人口以及饮酒史。结论深圳市耐药结核病疫情相对严重,加强对复治患者、外来人口和经常喝酒的涂阳肺结核患者的耐药性筛查及治疗管理。
Objective To understand the prevalence of Mycobacterium tuberculosis in Shenzhen and the influencing factors of drug resistance, so as to provide scientific basis for the development of a scientific strategy for the prevention and control of drug-resistant tuberculosis. Methods The smear-positive pulmonary tuberculosis patients newly infected with Mycobacterium tuberculosis in Shenzhen were studied in 2008, drug resistance test was conducted by proportional method to obtain drug resistance information of Mycobacterium tuberculosis, and other relevant information was obtained through questionnaire. Single Factor analysis using the chi-square test, analysis of variance, Kruskal-Wallis rank sum test, multivariate analysis using multi-class Logistic regression analysis. Results Among the 759 smear-positive pulmonary tuberculosis patients infected with Mycobacterium tuberculosis, the total resistance rate was 17.52% (133/759), the MDR rate was 5.14%, the single drug resistance rate was 9.88% and the multi-drug resistance rate was 2.50 %. Multi-classification Logistic regression analysis showed that there were three factors influencing the drug resistance of Mycobacterium tuberculosis: registration classification, floating population and drinking history. Conclusion The epidemic situation of drug-resistant tuberculosis in Shenzhen is relatively serious, and drug resistance screening and treatment management of smear-positive pulmonary tuberculosis patients with re-treatment, outside population and regular drinking are strengthened.