CAJ | 학술논문

目的：探索耐多药结核危险因素。方法回顾性分析2012年1月1日—2014年1月1日间大连市（市内四区）结核病医院所有同时有痰结核菌涂片及培养结果的患者954例的临床资料。利用临床相关因素比较及单因素危险因素分析，多因素危险因素分析统计耐药结核（ MDR－TB）和广泛耐药结核（ XDR－TB）的发生情况，致MDR和XDR的高危因素。结果初治者中耐多药肺结核MDR为4．69％，广泛耐多药肺结核XDR为0．88％。复治者中MDR为26．57％，XDR为6．27％。导致MDR／XDR的危险因素包括治疗方案不完整，剂量不足，应用喹诺酮或注射剂，依从性，糖尿病。结论治疗不规范，糖尿病是导致耐多药结核发生的重要因素，耐药机制复杂，需进一步探索。
목적：탐색내다약결핵위험인소。방법회고성분석2012년1월1일—2014년1월1일간대련시（시내사구）결핵병의원소유동시유담결핵균도편급배양결과적환자954례적림상자료。이용림상상관인소비교급단인소위험인소분석，다인소위험인소분석통계내약결핵（ MDR－TB）화엄범내약결핵（ XDR－TB）적발생정황，치MDR화XDR적고위인소。결과초치자중내다약폐결핵MDR위4．69％，엄범내다약폐결핵XDR위0．88％。복치자중MDR위26．57％，XDR위6．27％。도치MDR／XDR적위험인소포괄치료방안불완정，제량불족，응용규낙동혹주사제，의종성，당뇨병。결론치료불규범，당뇨병시도치내다약결핵발생적중요인소，내약궤제복잡，수진일보탐색。
Objective To explore the risk factors for MDR-TB and XDR-TB in Dalian patients.Methods We retrospec-tively analyzed the clinical records of 954 TB Patients with sputum and culture-proven MDR-or XDR-TB, who were reg-istered from January 1, 2012 to January 1, 2014 in the Dalian Tuberculosis Hospital.Results All TB patients were culture-positive for M.tuberculosis complex and had positive sputum-smear microscopy results.Among first-time patients, 4.69%were MDR-TB and 0.88%were XDR-TB.In recurrent patients, MDR-TB and XDR-TB were 26.57%and 6.27%, respectively.Significant risk factors for MDR/XDR-TB included incomplete treatment regimen, inadequate doses, previous use of a fluoroquinolone and injectable agent, poor compliance, and diabetes.Conclusion Inadequate initial regimen and dia-betes are important risks of drug resistance.The mechanisms of TB drug-resistance are complex and need further studies.