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中国东部湖州市结核病患者中耐多药结核病的流行病学特征及危险因素分析

Epidemiological characteristics and risk factors analysis of multidrug-resistant tuberculosis among tuberculosis population in Huzhou City, Eastern China.

作者信息

Chen Haiyan, Tong Zhaowei, Zhong Jianfeng, Zeng Qingqiu, Shen Bin, Qian Fuchu, Xiao Xin

机构信息

Department of Infection, Huzhou Central Hospital, Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, 1558 Sanhuan North Road, Wuxing District, Huzhou, Zhejiang, 313000, China.

出版信息

Open Life Sci. 2025 Mar 22;20(1):20251081. doi: 10.1515/biol-2025-1081. eCollection 2025.

Abstract

The aim of this study was to examine the prevalence of multidrug-resistant tuberculosis (MDR-TB) within the tuberculosis (TB) population in Huzhou City, identify associated risk factors, furnish reference values for clinical practice, and establish standardized anti-TB treatment regimens. Retrospectively analyzing data from TB patients in Huzhou City encompassed 2,261 cases with sputum smear positive and 1,754 cases with sputum smear negative from January 2016 to December 2022. There were 3.66%(147/4,015) TB patients identified as MDR-TB. Multivariate logistic regression analysis showed that the risk of developing MDR-TB in individuals with comorbidities was 9.17 times higher than in individuals without comorbidities (odds ratio [OR] = 9.17, 95% confidence interval [CI]: 6.5-12.93, < 0.001). The risk of progressing to MDR-TB with a positive sputum smear was 1.93 times higher than with a negative one (OR = 1.93, 95% CI: 1.35-2.77, < 0.001). The risk of developing MDR-TB was 1.69 times higher in patients had smoking history than in those without (OR = 1.69, 95% CI: 1.11-2.56, = 0.014). The main risk factors for developing MDR-TB were male patients, smoking history, sputum smear positive, farmer, body mass index ≤18.5, retreated cases, and those combination of diabetes or pneumoconiosis.

摘要

本研究旨在调查湖州市结核病(TB)人群中耐多药结核病(MDR-TB)的患病率,确定相关危险因素,为临床实践提供参考值,并建立标准化的抗结核治疗方案。回顾性分析湖州市结核病患者2016年1月至2022年12月的数据,包括2261例痰涂片阳性病例和1754例痰涂片阴性病例。有3.66%(147/4015)的结核病患者被确定为耐多药结核病。多因素logistic回归分析显示,合并症患者发生耐多药结核病的风险比无合并症患者高9.17倍(比值比[OR]=9.17,95%置信区间[CI]:6.5-12.93,<0.001)。痰涂片阳性进展为耐多药结核病的风险比痰涂片阴性高1.93倍(OR=1.93,95%CI:1.35-2.77,<0.001)。有吸烟史的患者发生耐多药结核病的风险比无吸烟史的患者高1.69倍(OR=1.69,95%CI:1.11-2.56,=0.014)。发生耐多药结核病的主要危险因素为男性患者、吸烟史、痰涂片阳性、农民、体重指数≤18.5、复治病例以及合并糖尿病或尘肺病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0209/11931660/f7d3667004c6/j_biol-2025-1081-fig001.jpg

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