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目的对嘉兴市老年人群肺结核患者的临床资料进行分析,探讨老年肺结核患者耐药菌群分布情况及耐药性的危险因素探析。方法 2013年1月至2016年3月,收集536例在嘉兴市各结核病定点诊治机构进行诊治的痰结核分枝杆菌培养阳性患者的临床资料,年龄≥60岁。结果 536例结核分枝杆菌阳性中,总耐药率为14.18%,仅1种药物耐药者构成比最高,占61.84%(47例),其次为耐2种及3种药物者,耐4种药物者较少,仅为2例,占2.63%,差异有统计学意义。异烟肼耐药率为10.07%,依次为链霉素耐药率6.34%,利福平耐药率3.17%,乙胺丁醇耐药率1.49%,差异有统计学意义。涂片阳性、影像学显示,有空洞以及有过治疗史是老年人群肺结核产生耐药性的危险因素,差异有统计学意义(P<0.05),性别、居住地区等因素差异无统计学意义(P>0.05)。结论老年人口是结核病发病的重点人群,且以单独一种药物耐药及耐异烟肼药物者居多,同时其产生耐药与涂片情况、有无空洞以及治疗史密切相关,临床上应规范使用药物,避免或延缓结核菌耐药性的产生。
Objective To analyze the clinical data of elderly patients with pulmonary tuberculosis in Jiaxing City and explore the distribution of drug-resistant bacteria in elderly patients with pulmonary tuberculosis and explore the risk factors for drug resistance. Methods From January 2013 to March 2016, 536 cases of sputum positive Mycobacterium tuberculosis patients who were diagnosed and treated in TB clinics in Jiaxing City were collected. The patients were ≥60 years old. Results Among the 536 positive cases of Mycobacterium tuberculosis, the total drug resistance rate was 14.18%. Only 1 drug resistant group had the highest constitutional ratio (61.84%, 47 cases), followed by 2 kinds and 3 kinds of drugs There were fewer kinds of drugs, only 2 cases, accounting for 2.63%, the difference was statistically significant. Isoniazid resistance rate was 10.07%, followed by streptomycin resistance rate 6.34%, rifampicin resistance rate 3.17%, ethambutol resistance rate 1.49%, the difference was statistically significant. Smear positive, imaging showed that there are holes and history of treatment is a risk factor for tuberculosis in the elderly population, the difference was statistically significant (P <0.05), gender, living area and other factors was not statistically significant ( P> 0.05). Conclusion The elderly population is the focus of tuberculosis, and drug resistance and isoniazid alone are the majority of drugs, and its drug resistance and smear, with or without cavity and the history of treatment are closely related to the clinical should be standardized Use drugs to avoid or delay the emergence of TB drug resistance.