2022 年第 8 期 第 17 卷

初始耐药肺结核的影响因素及患者临床转归分析

Analysis of influencing factors of initial drug-resistant pulmonary tuberculosis and patients′ clinical outcomes 

作者：孙金昊1陶磊1贺向红1刘明1张春艳2

英文作者：Sun Jinhao1 Tao Lei1 He Xianghong1 Liu Ming1 Zhang Chunyan2

单位：1河北省胸科医院结核五科，石家庄050000；2河北省胸科医院急诊科，石家庄050000

英文单位：1Department of Tuberculosis Ⅴ Hebei Chest Hospital Shijiazhuang 050000 China; 2Department of Emergency Hebei Chest Hospital Shijiazhuang 050000 China

关键词：肺结核；初始耐药；临床转归

英文关键词：Pulmonarytuberculosis;Initialdrug-resistance;Clinicaloutcomes

• 摘要：

• 目的 探讨2018—2020年河北省胸科医院初始耐药肺结核的影响因素及患者临床转归。方法 选取河北省胸科医院2018年1月至2020年12月结核菌培养阳性，且为初始耐药的100例肺结核患者作为观察组，并选取同期结核菌培养阳性的初始治疗敏感的100例肺结核患者作为对照组。比较2组患者一般资料，采用多因素Logistic回归模型分析初始耐药的影响因素，分析患者临床转归情况。结果 观察组男性、居住地为农村、已婚及外出打工比例均高于对照组［65.0%（65/100）比47.0%（47/100）、62.0%（62/100）比35.0%（35/100）、46.0%（46/100）比22.0%（22/100）、37.0%（37/100）比21.0%（21/100）］，卡介苗接种史比例低于对照组［34.0%（34/100）比68.0%（68/100）］，差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析结果显示，居住地为农村、已婚及外出打工是肺结核患者初始耐药的独立危险因素，而卡介苗接种史是独立保护因素（均P＜0.05）。100例初始耐药肺结核患者中，治愈62例、完成治疗疗程23例、治疗失败5例、死亡2例、其他情况8例。居住地为农村的初始耐药肺结核患者治愈率低于城市患者（P＜0.05）。结论 居住地为农村、已婚及外出打工是肺结核患者初始耐药的独立危险因素，而卡介苗接种史是独立保护因素。居住地为农村的初始耐药肺结核患者治愈率较低。

• Objective To discuss the influencing factors of initial drug-resistant pulmonary tuberculosis and patients′ clinical outcomes in Hebei Chest Hospital from 2018 to 2020. Methods From January 2018 to December 2020, 100 pulmonary tuberculosis patients with positive tuberculosis culture and initial drug-resistance were enrolled as the observation group. Another 100 pulmonary tuberculosis patients with positive tuberculosis culture and sensitivity to initial treatment were enrolled as control group. The general data of the two groups were compared. Multivariate Logistic regression model was used to analyze the influencing factors of initial drug-resistance. Patients′ outcomes were analyzed. Results The proportions of male, living in countryside, married and migrant workers in observation group was higher than those in control group ［65.0%（65/100） vs 47.0%（47/100）, 62.0%（62/100） vs 35.0%（35/100）, 46.0%（46/100） vs 22.0%（22/100）, 37.0%（37/100） vs 21.0%（21/100）］, and the proportion of Bacille Calmette-Guerin (BCG) vaccination history in observation group was lower than that in control group ［34.0%（34/100） vs 68.0%（68/100）］(all P<0.05). Multivariate Logistic regression analysis showed that living in countryside, married and migrant workers were independent risk factors of the initial drug-resistance in pulmonary tuberculosis patients, and the BCG vaccination history was the independent protective factor (all P<0.05). Among 100 patients with initial drug-resistant pulmonary tuberculosis, 62 cases were cured, 23 cases finished the course of treatment, 5 cases failed treatment, 2 cases died, and 8 cases were otherwise. The curative rate in initial drug-resistant pulmonary tuberculosis patients living in countryside was lower than that in the city (P<0.05). Conclusions  Living in countryside, married and migrant workers were independent risk factors of the initial drug-resistant in pulmonary tuberculosis patients, and BCG vaccination history is an independent prective factor. Patients with initial drug-resistant pulmonary tuberculosis living in countryside have low curative rate.