Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
J Evid Based Med. 2010 Aug;3(3):162-7. doi: 10.1111/j.1756-5391.2010.01088.x.
To analyze risk factors for drug resistance in pulmonary tuberculosis (PTB) inpatients.
Medical records of PTB inpatients in Chengdu Tuberculosis Hospital (CTH) from 2005 to 2007 were investigated retrospectively. A logistic regression model was used to analyze data.
A total of 330 records were included in the analysis. A history of tuberculosis treatment was associated with drug resistance with odds ratio (OR) 16.79 and 95% confidence interval (95% CI) [10.14, 27.80] for all patients. Among new patients, the significant risk factor was duration of illness (OR 0.27, 95% CI [0.16, 0.46]), and for previously treated patients, risk factors included age (OR 0.96, 95% CI [0.93, 0.99]), improper initial chemotherapy (OR 3.85, 95% CI [1.59, 10.00]), and improper handling by medical staff (OR 3.44, 95% CI [1.32, 8.96]).
A history of drug treatment is associated with drug resistance among PTB inpatients. Initial resistance becomes increasingly serious till 2007. To minimize the development of resistance, more personalized treatment and supervision should be used, and better training for medical staff is needed.
分析肺结核（PTB）住院患者耐药的危险因素。
回顾性调查了 2005 年至 2007 年成都结核病医院（CTH）住院肺结核患者的病历。采用逻辑回归模型进行数据分析。
共纳入 330 份病历进行分析。结核病治疗史与耐药有关，总患者的比值比（OR）为 16.79，95%置信区间（95%CI）为[10.14，27.80]。在新患者中，显著的危险因素是病程（OR 0.27，95%CI [0.16，0.46]），而对于既往治疗患者，危险因素包括年龄（OR 0.96，95%CI [0.93，0.99]）、初始化疗不当（OR 3.85，95%CI [1.59，10.00]）和医务人员不当处理（OR 3.44，95%CI [1.32，8.96]）。
肺结核住院患者的耐药与药物治疗史有关。初始耐药性在 2007 年之前变得越来越严重。为了最大限度地减少耐药性的发展，应采用更个性化的治疗和监督，并对医务人员进行更好的培训。
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