[A meta-analysis of risk factors for multidrug-resistant tuberculosis in China].

Objective: To explore the main risk factors of multidrug-resistant tuberculosis (MDR-TB) in China and to provide evidence-based evidence for MDR-TB preventon and control. Methods: All relevant literatures were searched in thedatabases, such as Pubmed, Web of Science and CNKI, Wanfang, VIP and SinoMed from 2000 to 2021. Quality evaluation and data extraction were carried out, and then a meta-analysis was performed using Stata 16.0 software. Results: A total of 59 literatures (36 cross-sectional and 23 case-control) including 75 793 participants were included in this study, and meta-analysis results showed age (OR=1.27, 95%CI: 1.05-1.54), education level (OR=1.29, 95%CI: 1.02-1.65), positive sputum smear (OR=2.56, 95%CI: 1.09-6.04), pulmonary cavity (OR=1.99, 95%CI: 1.57-2.52), course of disease (OR=4.25, 95%CI: 1.95-9.30), history of tuberculosis treatment (OR=6.42,95%CI:5.40-7.63), treatment interruption (OR=2.81, 95%CI: 1.50-5.29), irregular medication (OR=5.02, 95%CI: 2.95-8.54), adverse drug reactions (OR=4.27, 95%CI: 2.22-8.19), combined chronic obstructive pulmonary disease (COPD) (OR=2.21, 95%CI: 1.45-3.37), tuberculosis exposure history (OR=1.99, 95%CI: 1.36-2.91), smoking history (OR=1.35, 95%CI: 1.09-1.66) and floating population (OR=1.60, 95%CI: 1.04-2.44) were associated with the occurrence of MDR-TB. Conclusions: The high risk groups were farmer, low education level, pulmonary cavity, long course of disease, history of tuberculosis treatment, treatment interruption, irregular medication, adverse drug reaction, co-COPD, contact history of tuberculosis, smoking history, rural residence, and floating population. We should pay attention to high-risk groups, strengthen management and take effective measures such as early screening, knowledge education on tuberculosis, standardized and personalized treatment and whole-course supervision.目的： 通过荟萃分析探索我国耐多药结核病发生的主要危险因素，为耐多药结核病的预防控制提供循证依据。 方法： 检索英文数据库Pubmed、Web of Science和中文数据库中国知网、万方数据知识服务平台、维普期刊资源整合服务平台、中国生物医学文献服务系统，严格按照纳入和排除标准筛选文献，对纳入研究进行质量评价并提取数据资料，根据异质性大小采用随机效应模型或者固定效应模型合并效应值，同时进行敏感性分析和发表偏倚检验。 结果： 本研究共纳入59篇文献，荟萃分析结果显示40岁及以上（OR=1.27，95%CI：1.05~1.54）、文化程度低（OR=1.29，95%CI：1.02~1.65）、痰涂片阳性（OR=2.56，95%CI：1.09~6.04）、肺腔空洞（OR=1.99，95%CI：1.57~2.52）、病程长（OR=4.25，95%CI：1.95~9.30）、结核病治疗史（OR=6.42，95%CI：5.40~7.63）、治疗中断（OR=2.81，95%CI：1.50~5.29）、不规律服药（OR=5.02，95%CI：2.95~8.54）、药物不良反应（OR=4.27，95%CI：2.22~8.19）、合并慢性阻塞性肺疾病（OR=2.21，95%CI：1.45~3.37）、结核病患者接触史（OR=1.99，95%CI：1.36~2.91）、吸烟史（OR=1.35，95%CI：1.09~1.66）、流动人口（OR=1.60，95%CI：1.04~2.44）与耐多药结核病的发生相关。 结论： 农民、文化程度较低、肺腔空洞、病程较长、结核病治疗史、治疗中断、不规律服药、药物不良反应、合并慢性阻塞性肺疾病、结核病患者接触史、吸烟史、农村居住地以及流动人口是耐多药结核病发生的危险因素。应重视高危人群，加强管理并采取有效的措施如早期筛查、抗结核知识教育、标准化和个性化的治疗方案以及全程监督等。.