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目的 :探讨异烟肼、利福平用药史对肺结核多耐药性的影响。方法 :采用病例对照研究方法 ,选择耐药监测发现 /诊断的 2 0 9例多耐药肺结核患者、712例非多耐药菌阳性肺结核患者分别作为研究的病例组与对照组 ;应用单因素和多因素非条件 L OGISTIC回归进行统计分析。结果 :单因素分析 :异烟肼、利福平抗结核用药史和异烟肼、利福平非抗结核用药史与肺结核多耐药性在部分水平上有显著性较强联系 (P<0 .0 5 ) ;性别、年龄、职业无显著性联系。多因素分析 :异烟肼、利福平抗结核用药史和异烟肼、利福平非抗结核用药史与肺结核多耐药性均在各水平上有显著性较强联系 ,用药史1～ 5 9天 ,6 0～ 179天 ,≥ 180天的 OR值分别为 2 .2 43、5 .135、4.849与 3.0 5 8、2 .75 9、8.44 7(P值均 <0 .0 5 ) ;其他因素无显著性联系。结论 :异烟肼、利福平用药史是肺结核患者多耐药性的重要影响因素 ,然而其用药史越长 ,肺结核多耐药危险度并不一定相应增加。
Objective: To investigate the effects of isoniazid and rifampicin on the multi-drug resistance of pulmonary tuberculosis. Methods: A case-control study was conducted. A total of 209 patients with multi-resistant pulmonary tuberculosis were detected and diagnosed by drug resistance surveillance, and 712 non-multi-drug resistant pulmonary tuberculosis patients were selected as case group and control group respectively. Single factor and Multivariate non-conditional L OGISTIC regression analysis. Results: In the univariate analysis, the history of isoniazid, rifampin-resistant TB and isoniazid, the history of non-anti-tuberculosis drug use of rifampin and tuberculosis multi-drug resistance were significantly stronger at some levels (P <0 .0 5); sex, age, occupation no significant connection. Multivariate analysis: history of isoniazid, rifampicin anti-tuberculosis medication and isoniazid, rifampicin non-anti-tuberculosis drug use and tuberculosis multi-drug resistance were significantly stronger at all levels, medication history 1 ~ The odds ratios (ORs) of 5 9 days, 6 0 ~ 179 days and ≥ 180 days were 2.2, 43.5, 43.8, 49.9 and 3.0 5 8, 2.75, 9 and 8.44 respectively (P <0.05) ; Other factors no significant connection. Conclusion: The history of isoniazid and rifampicin is an important factor influencing multidrug resistance in patients with pulmonary tuberculosis. However, the longer the medication history, the more risk of multidrug resistance in tuberculosis does not necessarily increase accordingly.