Fleming M F, Krupitsky E, Tsoy M, Zvartau E, Brazhenko N, Jakubowiak W, McCaul M E
Department of Family Medicine, University of Wisconsin, 777 South Mills St, Madison, WI 53803, USA.
Int J Tuberc Lung Dis. 2006 May;10(5):565-70.
Alcohol use, tuberculosis (TB) drug resistance and human immunodeficiency virus (HIV) risk behavior are of increasing concern in Russian TB patients.
A prevalence study of alcohol use and HIV risk behavior was conducted in a sample of 200 adult men and women admitted to TB hospitals in St Petersburg and Ivanovo, Russia.
Of the subjects, 72% were men. The mean age was 41. Active TB was diagnosed using a combination of chest X-ray, sputum smears and sputum cultures. Sixty-two per cent met DSM-IV criteria for current alcohol abuse or dependence. Drug use was uncommon, with only two patients reporting recent intravenous heroin use. There was one case of HIV infection. The mean total risk assessment battery score was 3.4. Depression was present in 60% of the sample, with 17% severely depressed. Alcohol abuse/dependence was associated with an eight-fold increase in drug resistance (OR 8.58; 95% CI 2.09-35.32). Patients with relapsing or chronic TB were more likely to meet the criteria for alcohol abuse/dependence (OR 2.56; 95% CI 1.0-6.54).
Alcohol use disorders are common in patients being treated for active TB, and are associated with significant morbidity. Additional surveys are needed to examine the relationship between alcohol use disorders and anti-tuberculosis drug resistance.
在俄罗斯结核病患者中，酒精使用、结核（TB）耐药性及人类免疫缺陷病毒（HIV）风险行为日益受到关注。
对俄罗斯圣彼得堡和伊万诺沃结核病医院收治的200名成年男女样本进行了酒精使用及HIV风险行为的患病率研究。
受试者中，72%为男性。平均年龄为41岁。通过胸部X线、痰涂片和痰培养相结合的方法诊断活动性结核。62%的人符合当前酒精滥用或依赖的《精神疾病诊断与统计手册》第四版（DSM-IV）标准。药物使用情况不常见，只有两名患者报告近期使用过静脉注射海洛因。有1例HIV感染。总风险评估量表平均得分为3.4。60%的样本存在抑郁，其中17%为重度抑郁。酒精滥用/依赖与耐药性增加8倍相关（比值比[OR]8.58；95%置信区间[CI]2.09 - 35.32）。复发或慢性结核病患者更有可能符合酒精滥用/依赖标准（OR 2.56；95% CI 1.0 - 6.54）。
酒精使用障碍在活动性结核治疗患者中很常见，并与显著的发病率相关。需要进一步调查以研究酒精使用障碍与抗结核药物耐药性之间的关系。
