热带病与寄生虫学

热带病与寄生虫学 ›› 2025, Vol. 23 ›› Issue (6): 353-357.

• 结核病防控专题 • 上一篇    下一篇

2018—2022年重庆市利福平耐药肺结核患者治疗转归及影响因素分析

雷蓉蓉，汪清雅，吴成果，范君，张娅，张婷   

  1. 重庆市结核病防治所，重庆 400050
  • 收稿日期:2025-09-12 出版日期:2025-12-20 发布日期:2026-01-23
  • 通信作者: 张婷，E-mail: 934326349@qq.com
  • 作者简介:雷蓉蓉，女，硕士，副主任医师，研究方向：结核病防控。E-mail: lesleymo@163.com
  • 基金资助:
    重庆市首批公共卫生重点学科（专科）；重庆市科卫联合项目（2024ZDXM020）

Treatment outcomes and influencing factors analysis in rifampicin-resistant pulmonary tuberculosis patients in Chongqing, 2018-2022

LEI Rongrong, WANG Qingya, WU Chengguo, FAN Jun, ZHANG Ya, ZHANG Ting   

  1. Chongqing Institute of Tuberculosis Control and Prevention, Chongqing 400050, China
  • Received:2025-09-12 Online:2025-12-20 Published:2026-01-23

PDF (PC)

6

摘要： 目的 分析重庆市利福平耐药肺结核（rifampicin-resistant pulmonary tuberculosis, RR-PTB）患者治疗转归情况及影响因素，为当地结核病防控工作提供依据。方法 从中国疾病预防控制信息系统中获取2018—2022年重庆市登记的RR-PTB患者病案信息，采用描述流行病学方法分析患者登记、纳入治疗和治疗转归情况，通过logistic回归分析成功治疗的影响因素。结果 2018—2022年重庆市登记RR-PTB患者3 925例，男性2 876例，女性1 049例，男女性别比2.74∶1，平均年龄（46.99±17.63）岁。职业以农民（占37.32%，1 465/3 925）、家务及待业（占36.84%，1 446/3 925）为主，民族主要为汉族（占91.11%，3 576/3 925）。期间RR-PTB患者登记率为2.50/10万，纳入治疗率为94.32%（3 702/3 925），纳入治疗患者成功治疗率为64.72%（2 396/3 702）。多因素logistic分析结果显示，RR-PTB患者中，女性（OR=1.701，95%CI：1.420～2.037）、现住址为渝东南武陵山区（OR=1.454，95%CI：1.172～1.804）和首诊机构为耐药结核病定点医疗机构（OR=1.473，95%CI：1.263～1.718）是成功治疗的保护因素，45～54岁、55～64岁和≥65岁年龄段（OR=0.569，95%CI：0.413～0.784；OR=0.343，95%CI：0.247～0.475；OR=0.182，95%CI：0.130～0.253），职业为家务及待业、农民和其他（OR=0.270，95%CI：0.151～0.485；OR=0.281，95%CI：0.155～0.511；OR=0.328，95%CI：0.179～0.599）是成功治疗的危险因素。结论 重庆市RR-PTB疫情仍面临严峻挑战，成功治疗率还需进一步提升，建议优化耐药筛查和诊断治疗机构间转诊流程，重点关注农民、男性、中老年等人群。

关键词: 利福平耐药肺结核, 治疗转归, 影响因素, 重庆市

Abstract: Objective To analyze the treatment outcome and influencing factors in rifampicin-resistant pulmonary tuberculosis （RR-PTB） patients in Chongqing area for evidence for local tuberculosis prevention and control. Methods The medical record information of RR-PTB cases registered in Chongqing from 2018 to 2022 was retrieved from the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the registration, treatment inclusion and treatment outcome of RR-PTB patients, and logistic regression analysis was applied to identify the influencing factors associated with successful treatment. Results In total, 3 925 RR-PTB patients were registered in Chongqing from 2018 to 2022. Of RR-PTB cases, 2 876 were males and 1 049 females, with a male-to-female ratio of 2.74∶1. The average age was (46.99±17.63) years. Majority of the patients were farmers, homemakers and unemployed persons, who accounted for 37.32% (1 465/3 925) and 36.84% (1 446/3 925) respectively. The Han ethnicity was predominant, accounting for 91.11% (3 576/3 925). During 2018 and 2022, the RR-PTB patient registration rate was 2.50 per 100 000 population, the treatment enrollment rate, successful treatment rate among enrolled patients were 94.32% (3 702/3 925) and 64.72% (2 396/3 702), respectively. The results of multivariate logistic analysis showed that among RR-PTB patients, being female (OR=1.701, 95%CI: 1.420-2.037), living in the Wuling mountain area of southeast Chongqing (OR=1.454, 95%CI: 1.172-1.804), and having the initial diagnosis at a drug-resistant tuberculosis designated medical institution (OR=1.473, 95%CI: 1.263-1.718) were protective factors for successful treatment. Age groups of 45-54 years old, 55-64 years old, and ≥65 years old (OR=0.569, 95%CI: 0.413-0.784; OR=0.343, 95%CI: 0.247-0.475; OR=0.182, 95%CI: 0.130-0.253), and occupations of homemakers and unemployed persons, farmers, and others (OR=0.270, 95%CI: 0.151-0.485; OR=0.281, 95%CI: 0.155-0.511; OR=0.328, 95%CI: 0.179-0.599) were risk factors for successful treatment. Conclusion The RR-PTB epidemic situation in Chongqing still faces severe challenges. The success rate of treatment needs to be further enhanced. It is suggested to optimize the screening process for drug resistance and the referral procedures among diagnosis and treatment institutions, with a focus on farmers, men, and middle-aged and elderly individuals.

Key words: Rifampicin-resistant pulmonary tuberculosis, Treatment outcomes, Influencing factors, Chongqing Municipality

中图分类号: