目的 观察耐多药肺结核（MDR⁃PTB）患者的临床特征，分析 MDR⁃PTB 形成氟喹诺酮类 （FQs）耐药的危险因素。方法 收集安徽省胸科医院 2019 年 4 月至 2021 年 3 月收治的 230 例 MDR⁃PTB患 者，按照耐药类型分为两组：FQs 敏感组、FQs 耐药组，采用 χ2 检验进行组间比较分析形成 FQs 耐药的影响 因素，并进行多因素logistic回归分析筛选出独立危险因素。结果 治疗类型、二线抗结核药物使用情况、合并症、胸部CT表现、体质量指数（BMI）、年龄等是MDR⁃PTB 患者形成FQs 耐药的影响因素（均P < 0.05），多 因素logistic回归分析显示二线抗结核药物使用史及BMI < 18.5 kg/m2是MDR⁃PTB患者发生FQs耐药的独立 危险因素（均 P < 0.05）。结论 既往使用过二线药物及 BMI < 18.5 kg/m2是 MDR⁃PTB 患者形成 FQs 耐药的 独立危险因素，对临床快速诊断及鉴别诊断FQs耐药肺结核有一定的参考价值。

Objective To investigate the characteristics of the patients with multidrug⁃resistant pulmonary tuberculosis（MDR ⁃ PTB）and analyze the risk factors for developing the resistance of fluoroquinolones（FQs）. Methods A total of 230 MDR ⁃PTB patients admitted to Anhui Chest Hospital from April 2019 to March 2021 were collected and divided into the FQs sensitive group and the FQs resistant group according to the type of drug resistance. The chi ⁃ square test was used for comparative analysis of the factors related to FQs resistance，and multivariate logistic regression analysis was conducted to screen out independent risk factors. Results The chi ⁃ square test showed the risk factors related to FQs resistance were the type of treatment，the use of second⁃line anti⁃ tuberculosis drugs previously，comorbidities，chest CT findings，body mass index（BMI）and age（P < 0.05 for all）. Multivariate logistic regression analysis showed the use of second⁃line anti⁃tuberculosis drugs previously and BMI < 18.5 kg/m2 were independent risk factors（P < 0.05 for both）. Conclusion The use of second⁃line anti⁃tuberculosis drugs previously and BMI < 18.5 kg/m2 are independent risk factors for developing FQs drug resistance in MDR ⁃ PTB patients，which has certain reference value for clinical rapid diagnosis and differential diagnosis of FQs resis⁃ tant tuberculosis.