■调查中国中南部湖南省淋巴结结核(LNTB)的临床流行病学和耐药(DR)特征,为有效防治LNTB提供科学线索。
■我们回顾性收集了湖南省胸科医院结核分枝杆菌培养阳性的LNTB患者,中国中南部最大的结核病参考医院,从2013年1月到2021年12月。多重人口,从医院的电子病历中收集患者的临床和药敏数据。描述性统计方法,统计学方法采用卡方检验和logistic回归分析。
■在577个LNTB案例中,男性373人(64.64%),352(61.01%)是农民;大多数(161,33.10%)年龄在20-29岁;147(25.48%)患有简单的LNTB,350(60.66%)患有LNTB合并肺结核(PTB)(定义为LNTB-PTB),其中80例(13.86%)患有LNTB合并其他肺外结核(EPTB)(定义为LNTB-EPTB)。总计345(59.79%,345/577)LNTB患者有颈淋巴结感染,和简单的LNTB患者(81.63%,120/147)的感染比例高于LNTB-PTB(51.71%,181/350)和LNTB-EPTB(55.00%,44/80)(两个p值都<0.017),分别。LNTB-EPTB更倾向于有腹部结核性LN(20%,16/80)和至少四个结核性病变(22.50%,18/80)比简单的LNTB和LNTB-PTB。77例(13.34%)和119例(20.62%)对利福平(RIF)和异烟肼(异烟肼)耐药,分别为72例(12.48%)多药耐药(MDR),共有150例(26.00%)为DR(对至少一种RIF有抗性,INH,乙胺丁醇和链霉素)。年龄30-34岁和50-54岁的LNTB患者(与年龄<30岁的患者相比)是RIF抵抗(RR)的独立预测因子(OR分别为3.47和2.83;95%CI分别为1.64-7.35和1.08-7.46)。
■我们的研究揭示了湖南省LNTB的流行病学和DR特征,中国。在年轻人中发现高LNTB患病率,而在老年人中发现高RRLNTB患病率。建议我们应该进行进一步的研究,以阐明RR在LNTB中的发生,同时,加强LNTB的诊断和治疗,防止RR的出现。
UNASSIGNED: To investigate the clinical epidemiological and drug resistance (DR) characteristics of lymph node tuberculosis (LNTB) in Hunan Province which locates in South-central China, and to provide scientific clues for effective prevention and treatment of LNTB.
UNASSIGNED: We retrospectively collected LNTB patients with Mycobacterium tuberculosis culture positive at Hunan Chest Hospital, the biggest TB reference hospital in South-central China, from January 2013 to December 2021. The multiple demographic, clinical and drug susceptibility data of patients were collected from the hospital\'s electronic patient records. Descriptive statistical methods, Chi-square test and logistic regression analysis were employed as statistical methods.
UNASSIGNED: Of the 577 LNTB cases, 373 (64.64%) were males, 352 (61.01%) were farmers; majority (161, 33.10%) aged at 20-29 years old; 147 (25.48%) had simple LNTB, 350 (60.66%) had LNTB combined with pulmonary TB (PTB) (defined as LNTB-PTB), and 80 (13.86%) had LNTB combined with other extrapulmonary TB (EPTB) (defined as LNTB-EPTB). A total of 345 (59.79%, 345/577) LNTB patients had cervical node infection, and the simple LNTB patients (81.63%, 120/147) had higher proportion of this infection than LNTB-PTB (51.71%, 181/350) and LNTB-EPTB (55.00%, 44/80) (both p values <0.017), respectively. LNTB-EPTB was more inclined to have abdominal tuberculous LNs (20%, 16/80) and at least four tuberculous lesions (22.50%, 18/80) than simple LNTB and LNTB-PTB. Seventy-seven (13.34%) and 119 (20.62%) were resistant to rifampicin (RIF) and isoniazid (INH), respectively; 72 (12.48%) were multi-drug resistant (MDR), and a total of 150 (26.00%) were DR (resistant to at least one of RIF, INH, ethambutol and streptomycin). LNTB patients aged 30-34 and 50-54 years old (compared to those aged <30 years) were independent predictors of RIF resistance (RR) (ORs were 3.47 and 2.83, respectively; 95% CIs were 1.64-7.35 and 1.08-7.46, respectively).
UNASSIGNED: Our study disclosed the epidemiological and DR characteristics of LNTB in Hunan Province, China. High LNTB prevalence was found in younger people while high RR LNTB prevalence was found in older ones, suggesting that we should conduct further studies to clarify the occurrence of RR in LNTB, meanwhile, strengthen the diagnoses and treatments of LNTB to prevent the emergence of RR.