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目的探讨湘潭县农村居民耐多药结核病患病的危险因素,为农村耐多药结核病防治提供依据。方法采用1∶1配对病例对照研究方法,在湘潭县“结核病信息管理系统”中抽取耐多药结核病与非耐多药结核病(泛耐药患者除外)的农村居民患者各76名进行入户问卷调查,采用条件logistic回归分析耐多药结核病患病的危险因素。结果单因素分析显示,患者家庭总收入低、低体重(BMI<18.5)、文化水平低、结核病接触史、既往不规则结核病治疗史、复治等方面的差异有统计学意义(P<0.05);多因素条件logistic回归分析显示,家庭总收入低、结核病接触史、既往不规则结核病治疗史是结核病患者产生耐多药的主要危险因素OR及95%CI分别为1.667(1.105~2.391)、3.471(2.230~5.314)、4.836(3.119~7.538)。结论需采取针对性的措施提高结核病患者治疗依从性,并对家庭困难的结核病患者提供更多的政策支持。
Objective To investigate the risk factors of MDR-TB in rural residents in Xiangtan County and provide evidence for the prevention and treatment of MDR-TB in rural areas. Methods A 1: 1 matched case-control study was conducted in 76 rural residents who were resistant to MDR-TB and non-MDR-TB in Xiangtan County’s Tuberculosis Information Management System Household survey, using conditional logistic regression analysis of MDR-TB risk factors. Results Univariate analysis showed that there was significant difference in total family income, low birth weight (BMI <18.5), low educational level, history of exposure to TB, previous history of treatment of irregular TB, retreatment, etc (P <0.05) ; Multivariate conditional logistic regression analysis showed that the total family income is low, the history of tuberculosis exposure, the history of previous irregular tuberculosis treatment is the main risk factor for tuberculosis patients with multi-drug resistance OR and 95% CI 1.667 (1.105 ~ 2.391), 3.471 (2.230 ~ 5.314), 4.836 (3.119 ~ 7.538). Conclusions Targeted measures need to be taken to improve the treatment compliance of TB patients and to provide more policy support to TB patients with family difficulties.