2022 年第 11 期 第 17 卷

肺结核耐药高危人群对异烟肼耐药的危险因素分析

Risk factors of isoniazid resistance in high-risk population with drug resistance to pulmonary tuberculosis

作者：马清艳党萍侯莉莉康冠楠

英文作者：Ma Qingyan Dang Ping Hou Lili Kang Guannan

单位：河北省胸科医院结核四科，石家庄050041

英文单位：The Fourth Department of Tuberculosis Hebei Chest Hospital Shijiazhuang 050041 China

关键词：肺结核；异烟肼；耐药

英文关键词：Pulmonarytuberculosis;Isoniazid;Drugresistance

• 摘要：

• 目的 探讨肺结核耐药高危人群对异烟肼耐药的危险因素。方法 回顾性分析2020年1月至2021年12月于河北省胸科医院治疗的150例肺结核耐药高危人群的临床资料，主要包括性别、职业、年龄、民族、登记分类、居住地、吸烟、饮酒情况等。分析肺结核耐药高危人群的异烟肼耐药率，并采用多因素Logistic回归方法分析肺结核耐药高危人群异烟肼耐药的危险因素。结果 150例肺结核耐药高危人群中，异烟肼耐药患者为38例，耐药率为25.3%。单因素分析结果显示,肺结核耐药高危人群中异烟肼耐药与性别、职业、登记分类、居住地、吸烟有关（均P＜0.05）。多因素Logistic回归分析结果显示，复治失败与慢性患者、初治失败、复发、居住地为农村及吸烟是肺结核耐药高危人群中异烟肼耐药的危险因素（比值比=3.762、1.699、2.387、9.450、4.362，95%置信区间：1.350～10.486、1.621～1.726、2.342～2.433、1.293～69.089、1.162～16.379，P=0.011、＜0.001、＜0.001、0.027、0.029）。结论 居住地为农村、吸烟、复治失败与慢性患者、复发及初治失败是肺结核耐药高危人群对异烟肼耐药的危险因素。

• Objective To explore the risk factors of isoniazid resistance in high-risk population with drug resistance to pulmonary tuberculosis. Methods The clinical data of 150 high-risk patients with drug resistance to pulmonary tuberculosis in Hebei Chest Hospital from January 2020 to December 2021 were retrospectively analyzed, mainly including gender, occupation, age, nationality, registration classification, residence, smoking, drinking, etc. The isoniazid resistance rate of high-risk patients with drug resistance to pulmonary tuberculosis was analyzed. The risk factors of isoniazid resistance in high-risk patients with drug resistance to pulmonary tuberculosis were analyzed by multifactor Logistic regression method. Results Among the 150 high-risk patients with drug resistance to pulmonary tuberculosis, 38 cases were isoniazid resistance, and the drug resistance rate was 25.3%. Univariate analysis showed that isoniazid resistance was related to gender, occupation, registration classification, residence and smoking (all P＜0.05). Multivariate Logistic regression analysis showed that retreatment failure and chronic patients, initial treatment failure, recurrence, residence in countryside and smoking were the risk factors of isoniazid resistance in high-risk patients with drug resistance to pulmonary tuberculosis (odds ratio=3.762, 1.699, 2.387, 9.450, 4.362, 95% confidence interval: 1.350-10.486, 1.621-1.726, 2.342-2.433, 1.293-69.089, 1.162-16.379, P=0.011, ＜0.001, ＜0.001, 0.027, 0.029). Conclusion Residence in countryside, smoking, recurrence failure and chronic patients, recurrence and initial failure are risk factors for isoniazid resistance in high-risk patients with drug resistance to pulmonary tuberculosis.