中文摘要：

目的掌握德清县耐药肺结核流行模式及其危险因素，为肺结核的治疗和综合防制提供科学依据。方法收集2004—2005年德清县结防所诊断并报告的肺结核病例，调查病例的一般情况（年龄、性别、职业等）和社会经济状况（既往治疗史、体质指数、患者接触史、个人年收入、家庭年收入等），所有病例均进行痰培养，对分离到的结核菌株进行菌型鉴定和药物敏感试验。结果182例肺结核患者被纳入研究，确定为牛结核分枝杆菌5株（2．7％），结核分枝杆菌177株（97．3％）。总耐药率54．9％（100／182），13例为耐多药肺结核（MDR．TB）。初始MDR．TB率和其他耐药（ODR．TB）率分别为3．8％和46．6％，获得性MDR．TB率和其他耐药率分别为16．3％和5i．0％。单因素分析显示，年龄、既往治疗史、肺结核患者接触史、个人和家庭收入与IDR-TB发生有关（P〈0．05），性别、职业、肺结核患者接触史与其他耐药有关（P〈0．05）。多因素分析表明，年龄（OR：1．22，95％CI：1．12．6．63）、既往治疗史（OR：4．98，95％CI：1．56～8．03）、肺结核患者接触史（OR=7．84，95％CI：1．71～25）和个人收入与MDR．TB发生有关。而肺结核患者接触史（OR=2．9，95％CI：1．13～7．52）与其他耐药结核病发生相关。结论德清县耐多药肺结核流行尚不严重．既往治疗史是MDR．TB发生的重要原因。农村经济状况较差的人群和老年患者是MDR-TB发生的高危人群。

英文摘要：

Objective To Objective To understand the epidemic pattern of drug-resistant （DR） tuberculosis and its risk factors and to provide scientific basis for treatment and prevention. Methods Patients diagnosed with tuberculosis from April 1 in 2004 to March 31 in 2005 were face-to-face interviewed about demographic characteristics （age, gender, occupation, etc. ） and socioeconomic status （treatment history, BMI, contact history with tuberculosis patients, annual income, etc）. Each subject was asked to provide three specimens of sputum. All specimens were cultured in 37℃ to discriminate the type of strains, and then susceptibility tests were conducted. Results Of 182 strains isolated, 5 strains were M Boris （2.7%） and 177 strains were M TB （97.3%）. The proportion of drug-resistant strains was 54.9%, and 13 strains （7.1%） of them were multi-drug resistant tuberculosis （MDR-TB）. The rates of initial MDR and other drug-resistant tuberculosis （ODR-TB） were 3.8% and 46.6% respectively, while acquired rates were 16.3 % and 51.0 % respectively. Univariate analysis showed that age, treatment history, contact history with tuberculosis patients, individual and household annual income were significantly associated with MDR-TB （P 〈 0.05）; gender, occupation, and contact history were significantly associated with other resistant tuberculosis. Logistic regression analysis indicated that age （OR = 1.22, 95 % CI： 1.12- 6.63）, treatment history （OR = 4.98, 95% CI： 1.56 - 8.03）, contact history （OR = 7.84, 95%CI： 1.71 -25） and lower individual income were the risk factors of MDR-TB, and contact history （OR = 2.9, 95%CI： 1.13 - 7.52） was the risk factor of other resistant tuberculosis. Conclusion This study implies a low prevalence of MDR-TB in Deqing County. Treatment history is one of the most risk factors of MDR-TB. The poorer and the elder are the high risk population of MDR-TB.