학술논문
203例老年肺结核合并2型糖尿病患者耐药状况及影响因素分析 / Analysis of drug resistance status and influencing factors in 203 aged patients with pulmonary tuberculosis combined with type 2 diabetes
Document Type
Academic Journal
Author
Source
结核与肺部疾病杂志 / Journal of Tuberculosis and Lung Disease. 5(1):28-36
Subject
Language
Chinese
ISSN
2096-8493
Abstract
目的:分析老年肺结核合并2型糖尿病患者耐药特征及影响因素.方法:采用回顾性研究方法,收集2021年1月1日至2022年12月31日成都市公共卫生临床医疗中心收治的痰培养阳性且菌种鉴定为结核分枝杆菌的203例老年肺结核合并2型糖尿病患者的药物敏感性试验结果及相关临床资料,采用单因素和多因素logis tic回归模型分析其耐药特征及发生耐药的影响因素.结果:203例老年肺结核合并糖尿病患者的总耐药率为40.4％(82/203),单耐药率为12.3％(25/203),多耐药率为4.9％(10/203),耐多药率为12.8％(26/203).14种抗结核药物的总耐药率由高至低前3位依次为异烟肼(INH)[22.7％(46/203)]＞利福平(RFP)[15.8％(32/203)]＞链霉素(Sm)[14.8％(30/203)],且对莫西沙星(Mfx)[11.3％(23/203)]和左氧氟沙星(Lfx)[10.8％(22/203)]的耐药率均较高.多因素logistic回归模型分析显示,复治、低蛋白血症和CD4+T淋巴细胞绝对计数＜414个/μ1均是老年肺结核合并糖尿病患者发生耐药的独立危险因素(OR=4.528,95％CI:2.031～10.099,P＜0.001;OR=2.106,95％CI:1.116～3.972,P=0.021;OR=1.887,95％CI:1.011～3.532,P=0.046).结论:老年肺结核合并糖尿病患者耐药率较高,且以一线抗结核药物耐药为主,应积极开展耐药筛查,并对复治、有低蛋白血症和CD4+T淋巴细胞绝对计数＜414个/μl的患者尽早采取防治措施.
Objective:To explore the characteristics and the related influencing factors of drug resistance in aged pulmonary tuberculosis patients combined with type 2 diabetes.Methods:A retrospective study was conducted to collect the drug sensitivity test results and clinical data of 203 aged pulmonary tuberculosis patients combined with type 2 diabetes who were admitted to Public Health Clinical Center of Chengdu from January 1,2021 to December 31,2022 and identified as Mycobacterium tuberculosis with positive sputum culture.The characteristics of drug resistance and the influencing factors of drug resistance were analyzed by univariate and multivariate logistic regression models.Results:In 203 aged pulmonary tuberculosis patients combined with type 2 diabetes,the total drug resistance rate of was 40.4％(82/203),the rate of single drug resistance was 12.3％(25/203),the rate of poly-resistant tuberculosis was 4.9％(10/203)and the rate of multi-drug resistant tuberculosis was 12.8％(26/203).The top three drug resistance rates of 14 anti-tuberculosis drugs were INH(22.7％(46/203))＞RFP(15.8％(32/203))＞Sm(14.8％(30/203)),and the drug resistance rates of Mfx(11.3％(23/203))and Lfx(10.8％(22/203))were higher.Multivariate logistic regression analysis showed that retreatment(OR=4.528,95％CI:2.031-10.099,P＜0.001),hypoproteinemia(OR=2.106,95％CI:1.116-3.972,P=0.021)and CD4+T lymphocyte count＜414 cell/μl(OR=1.887,95％CI:1.011-3.532,P=0.046)were independent risk factors for drug resistance in aged pulmonary tuberculosis patients combined with type 2 diabetes.Conclusion:The drug resistance rate of aged pulmonary tuberculosis patients combined with type 2 diabetes is high,and the drug resistance is mainly caused by first-line anti-tuberculosis drugs.Drug resistance screening should be actively carried out,and prevention and control measures should be taken as soon as possible for patients with retreatment,hypoproteinemia and CD4+T lymphocyte count＜414 cell/μl.
Objective:To explore the characteristics and the related influencing factors of drug resistance in aged pulmonary tuberculosis patients combined with type 2 diabetes.Methods:A retrospective study was conducted to collect the drug sensitivity test results and clinical data of 203 aged pulmonary tuberculosis patients combined with type 2 diabetes who were admitted to Public Health Clinical Center of Chengdu from January 1,2021 to December 31,2022 and identified as Mycobacterium tuberculosis with positive sputum culture.The characteristics of drug resistance and the influencing factors of drug resistance were analyzed by univariate and multivariate logistic regression models.Results:In 203 aged pulmonary tuberculosis patients combined with type 2 diabetes,the total drug resistance rate of was 40.4％(82/203),the rate of single drug resistance was 12.3％(25/203),the rate of poly-resistant tuberculosis was 4.9％(10/203)and the rate of multi-drug resistant tuberculosis was 12.8％(26/203).The top three drug resistance rates of 14 anti-tuberculosis drugs were INH(22.7％(46/203))＞RFP(15.8％(32/203))＞Sm(14.8％(30/203)),and the drug resistance rates of Mfx(11.3％(23/203))and Lfx(10.8％(22/203))were higher.Multivariate logistic regression analysis showed that retreatment(OR=4.528,95％CI:2.031-10.099,P＜0.001),hypoproteinemia(OR=2.106,95％CI:1.116-3.972,P=0.021)and CD4+T lymphocyte count＜414 cell/μl(OR=1.887,95％CI:1.011-3.532,P=0.046)were independent risk factors for drug resistance in aged pulmonary tuberculosis patients combined with type 2 diabetes.Conclusion:The drug resistance rate of aged pulmonary tuberculosis patients combined with type 2 diabetes is high,and the drug resistance is mainly caused by first-line anti-tuberculosis drugs.Drug resistance screening should be actively carried out,and prevention and control measures should be taken as soon as possible for patients with retreatment,hypoproteinemia and CD4+T lymphocyte count＜414 cell/μl.