摘要
目的了解本地区初治培阳肺结核患者不同时期耐药变化情况,为制定和完善结核病控制措施改进结核病防控工作提供依据。方法收集1993.1-1995.12(下称A期)和2013.1-2015.12(下称B期)前后两个时期在我院住院的痰结核分枝杆菌培养(+),并有药物敏感试验结果的初治肺结核患者501例(其中A期90例,B期411例),就其有关项目进行调查分析。结果 AB前后两个时期总耐药率分别为62.2%(56/90)和42.8%(176/411),耐两种以上药物的耐药率分别为33.3%(30/90)和15.8%(65/411),其中MDR率分别为12.2%(11/90)和4.1%(17/411);耐药顺位由高至低A期为:RFP 26.7%(24/90),INH22.2%(20/90),EMB 21.1%(19/90),Sm 18.9%(17/90),PAS 17.8%(16/90),Cm 15.6%(14/90),Am6.7%(6/90);B期为PZA 21.9%(90/411),INH 13.6%(56/411),PAS 9.5%(39/411),Pto 9.0%(37/411),RFP 8.0%(33/411),Lfx 6.3%(26/411),Cm 1.9%(8/411),Am 1.7%(7/411)。AB前后两个时期相比,不论总耐药率(X^2=11.8,P<0.01),还是耐多药率(X^2=7.57,P<0.01)以及耐各药的任何耐药率(INH X^2=4.24,P<0.05,RFP X^2=25.44,P<0.01,EMB X^2=17.76,P<0.01,PAS X^2=5.19,P<0.05,Am X^2=5.37,P<0.05,Cm X^2=29.41,P<0.01)均为明显下降。结论本地区结核病控制工作与以往相比有较大进步,但当前结核耐药性在全国仍处于较高水平,应预继续努力,加强耐药监测,不断采取措施,提高防控水平,减少耐药结核病,降低结核病疫情。
Objective To understand TB drug resistance in initial-treated positive pulmonary tuberculous patients during different periods, in order to provide basis of the establishment and improvement of TB control. Meth-ods Through collecting the patientssputum cultures of 1993. 1-1995. 12 （ the period A） and 2013. 1-2015. 12 （the period B）, the drug sensitivity test results of 501 initial-treated patients （90 in period A and 411 in period B） were analyzed. Results The TB total resistant rate of the two periods were 62. 2% （ 56/90 ） and 42. 8% （ 176/411）. The resistant rate to more than two drugs was 33. 3% （30/90） in period A and 15. 8% （65/411） in period B, in which MDR rate was 12. 2% （11/90） and 4. 1% （17/411） respectively. The resistant rate from high to low was RFP of 26. 7% （ 24/90 ） , INH of 22. 2% （ 20/90 ） , EMB of 21. 1% （ 19/90 ） , Sm of 18. 9% （ 17/90 ） , PAS of 17. 8% （16/90）, Cm of 15. 6% （14/90）, and Am of 6. 7% （6/90） in period A, and PZA of 21. 9% （90/411）, INH of 13. 6% （56/411）, PAS of 9. 5% （39/411）, Pto of 9. 0% （37/411）, RFP of 8. 0% （33/411）, Lfx of 6. 3%（26/411）, Cm of 1. 9% （8/411）, and Am of 1. 7%（7/411） in period B. Compare with period A and B, no mater the total resistance rate （X2 =11. 8, P〈0. 01）, multi drug resistance rate （X2 =7. 57, P〈0. 01） or any drug resist-ance rate （INH X2 =4. 24, P〈0. 05;RFP X2 =25. 44, P〈0. 01;EMB X2 =17. 76, P〈0. 01;PAS X2 =5. 19, P〈0. 05;Am X2 =5. 37, P〈0. 05;Cm X2 =29. 41, P〈0. 01） decreased significantly. Conclusion Compare with the past, tuberculosis control in the region has made great progress. Current TB resistance in the country is still at a high level, and we should continue to work hard to strengthen drug resistance monitoring, constantly take measures, improve the level of prevention and control, reduce drug-resistant tuberculosis, and reduce tuberculosis epidemic.
出处
《临床肺科杂志》
2017年第11期2033-2036,共4页
Journal of Clinical Pulmonary Medicine
关键词
结核
肺
痰
抗药性
细菌
tuberculosis
lung
sputum
drug resistance
bacteria
