Abstract:

Objective　Analyze the epidemiological characteristics and treatment outcomes of drug-resistant pulmonary tuberculosis patients in Baoji city during six years. Methods　The general data of 211 patients with drug-resistant pulmonary tuberculosis in Baoji city from January 1, 2016 to December 31, 2021 were collected, including age, gender, occupation, previous history of anti-tuberculosis treatment, patient diagnosis type, registration classification, treatment classification, whether receiving anti-tuberculosis treatment, reasons for stopping treatment, drug sensitivity results, and treatment outcome. Chi-square trend test and χ² test were used for statistical analysis. Results　From 2016 to 2021, a total of 211 cases of drug-resistant pulmonary tuberculosis were reported in Baoji city. The average annual incidence rate was 1.02 per 100,000 people, and the incidence rate showed an overall upward trend (P<0.05). There were 144 male cases (68.25%) and 67 female cases (31.75%), with a male-to-female ratio of 2.15:1; the age range was 15 to 85 years old, with 153 cases (72.51%) aged 25 to 64 years old; 149 cases (70.62%) were farmers. The highest average incidence rate was in the mountainous county of Long county (1.83 per 100,000), followed by the urban district of Jintai district (1.35 per 100,000) and the mountainous county of Linyou county (1.17 per 100,000). Comparisons of the average incidence rates among different counties showed statistically significant differences (P<0.05). The top three drugs with drug resistance were rifampicin [93.36% (197/211)], isoniazid [74.88% (158/211)], and ethambutol [31.28% (66/211)], and the resistance rate of fluoroquinolone drugs was relatively low (P<0.05). 158 cases (74.88%) were successfully treated (including cure and completion of treatment course), and 53 cases (25.12%) were not successfully treated. The top three reasons for unsuccessful treatment were drug intolerance [41.51% (22/53)], poor treatment compliance [22.64% (12/53)], and refusal of treatment (including excessive economic burden) [13.21% (7/53)]. Conclusion　From 2016 to 2021, the incidence of drug-resistant pulmonary tuberculosis in Baoji city was relatively high. The patients were mainly male, middle-aged and young adults, and farmers. The drug resistance was mainly composed of rifampicin, isoniazid and ethambutol. The treatment success rate was relatively high. The reasons for unsuccessful treatment were mainly drug intolerance, poor treatment compliance and refusal to treat (including excessive economic burden).

Key words:

Drug-resistant pulmonary tuberculosis, Epidemiology, Treatment outcome

摘要：

目的　分析宝鸡市6年耐药肺结核患者流行病学特征及治疗转归情况。方法　收集2016年1月1日至2021年12月31日宝鸡市耐药肺结核患者（211例）的一般资料，包括年龄、性别、职业、既往抗结核病史、患者诊断分型、登记分类、治疗分类、是否接受抗结核治疗、停止治疗原因、药敏结果、治疗转归等。采用卡方趋势检验和χ²检验进行统计学分析。结果　2016年至2021年宝鸡市共报告耐药肺结核患者211例，年平均报告发病率为1.02/10万，发病率整体呈上升趋势（P<0.05）。男144例（68.25%），女67例（31.75%），男女性别比为2.15∶1；年龄范围15～85岁，25～64岁153例（72.51%）；农民149例（70.62%）。年平均发病率最高是山区县陇县（1.83/10万），其次是城区金台区（1.35/10万）、山区县麟游县（1.17/10万）；不同县区平均发病率比较，差异有统计学意义（P<0.05）。耐药性排名前3的药物分别为利福平［93.36%（197/211）］、异烟肼［74.88%（158/211）］和乙胺丁醇［31.28%（66/211）］，氟喹诺酮药物耐药性相对较低（P<0.05）。成功治疗（治愈+完成疗程）158例（74.88%），未成功治疗53例（25.12%）；未成功治疗原因排名前3分别为药物不耐受［41.51%（22/53）］、治疗依从性差［22.64%（12/53）］和拒绝治疗（含经济负担过重）［13.21%（7/53）］。结论　2016年至2021年宝鸡市耐药肺结核发病率较高，患者以男性、靑中年、农民为主，耐药药物以利福平、异烟肼、乙胺丁醇为主，治疗成功率较高，未成功治疗的原因以药物不耐受、治疗依从性差和拒绝治疗（含经济负担过重）为主。

关键词:

耐药肺结核, 流行病学, 治疗转归