武汉地区老年结核病耐药病例流行特征及疾病负担研究

张丽萍; 柳湘洁; 刘晓霞; 魏婷; 王燕; 李倩

doi:10.7619/jcmp.20244924

武汉地区老年结核病耐药病例流行特征及疾病负担研究

Epidemic characteristics and disease burden of drug-resistant tuberculosis cases in the elderly in Wuhan

摘要

摘要:
目的分析武汉地区老年结核病耐药病例流行特征及疾病负担。
方法回顾性分析2019年1月—2022年12月武汉地区老年肺结核病患者的临床资料。收集患者的痰液分离结核分枝杆菌，采用比例法对分离的结核分枝杆菌进行药敏试验。分析耐药肺结核的流行特征及患者的疾病直接经济负担。
结果共纳入972例结核分枝杆菌阳性老年患者，其总结核耐药率为21.19%(206/972)。男性、居住地为农村、教育程度为小学及以下、治疗史为复治可增加老年结核病患者发生耐药的风险(P < 0.05)。老年耐药结核病患者的直接经济负担为24 101.52(8 283.98, 39 598.89)元人民币，间接经济负担为1 858.64(528.66, 3 085.26)元人民币。
结论老年肺结核耐药的发生率较高，其中男性、农村居住、教育程度低、结核复治为老年结核病患者发生耐药的危险因素，且发生耐药后其经济负担较重。

Abstract:
Objective To analyze the epidemiological characteristics and disease burden of drug-resistant tuberculosis cases among elderly patients in Wuhan.
Methods Clinical data of elderly patients with pulmonary tuberculosis in Wuhan from January 2019 to December 2022 were retrospectively analyzed. Sputum samples were collected for Mycobacterium tuberculosis isolation, and drug susceptibility testing was performed using the proportion method. The epidemiological characteristics of drug-resistant tuberculosis and the direct economic burden of the patients were analyzed.
Results A total of 972 elderly patients with positive Mycobacterium tuberculosis tests were included. The overall tuberculosis drug resistance rate was 21.19% (206/972). Male, rural residence, lower education level (primary school or below) and retreatment history significantly increased the risk of developing drug-resistant tuberculosis (P < 0.05). The direct economic burden for elderly patients with drug-resistant tuberculosis was 24, 101.52 (8, 283.98, 39, 598.89) RMB, and the indirect economic burden was 1, 858.64 (528.66, 3, 085.26) RMB.
Conclusion The incidence of drug resistance in elderly tuberculosis is high, and male, rural residence, low education level and tuberculosis retreatment are the risk factors for drug resistance in elderly tuberculosis, and their economic burden is heavy after drug resistance.

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