2009—2010年北京市登记复治肺结核患者的耐药状况研究  

The study of drug resistance of retreatment tuberculosis patients in Beijing 2009—2010

作　　者：罗萍[1] 张天豪[2] 高志东[2] 邢青[3] 赵瑶[1] 易俊莉[3] 王甦民[3] 

机构地区：[1]北京结核病控制研究所门诊部,北京100035 [2]北京结核病控制研究所防控科,北京100035 [3]北京结核病控制研究所中心实验室,北京100035

出　　处：《中国防痨杂志》2012年第11期704-707,共4页Chinese Journal of Antituberculosis

基　　金：北京市首都发展基金联合攻关课题项目(2007-1020)

摘　　要：目的了解北京地区复治肺结核患者的耐药状况,为结核病防治对策的制定提供依据。方法收集2009—2010年北京市复治肺结核患者276例,对分离出的同时有一、二线药物敏感度试验结果的结核分枝杆菌菌株195株进行抗结核药品耐药情况检测并进行分析。耐药率之间的差异性比较采用χ2检验,显著性水平设定为α=0.05。结果195株结核分枝杆菌菌株对一线抗结核药品的耐药率为56.4%(110/195),对二线抗结核药品的耐药率为63.6%(124/195),耐多药率28.2%(55/195),广泛耐药率3.1%(6/195);在检测的9种抗结核药品中,耐药率顺位前5位依次为丙硫异烟胺57.9%(113/195)、异烟肼42.6%(83/195)、乙胺丁醇36.4%(71/195)、链霉素34.9%(68/195)和利福平33.8%(66/195);耐药率在性别[男性78.8%(119/151),女性79.5%(35/44)]、年龄分布["15～岁"82.9%(34/41),"30～岁"83.8%(57/68),"45～岁"79.2%(38/48),"60～岁以上"65.8%(25/38)]、地区[北京市79.2%(103/130)、外地78.5%(51/65)]和登记分类[复发77.7%(122/157),初治失败84.6%(11/13),其他复治84.0%(21/25)]等方面比较,差异均无统计学意义(χ2值分别为0.011、5.328、0.015、0.824;P值均>0.05)。结论北京地区复治肺结核患者耐药状况比较严重,应加强对现有治疗管理方法的研究。Objective To understand the drug resistance of retreatment tuberculosis patients in Beijing, and to provide evidence for Beijing TB control. Methods One hundred and ninty-five retreatment tuberculosis patients registered in TB control organizations from 2009 to 2010 that had performed both the 1st-line and 2nd-line drug sus ceptibility tests were collected and analyzed. Chisquare test was used for comparing difference of drug resistant rate, a=0.05. Results The resistance rate of lstline anti-TB drugs was 56.4%（110/195）, for 2nd-line anti-TB drug resistance rate was 63.6%（124/195）, multidrug resistant（MDR） rate was 28. 2%（55/195）,extensivelydrug resistant（XDR） rate was 3.1%（6/195）. Drug resistance rate in the top 5 of the 9 drugs tested were Pto 57.9% （113/195）, INH 42.6%（83/195）, EMB 36.4%（71/195）, S 34. 9%（68/195） and RFP 33.8%（66/195）. There were no significant difference of drug resistance in different gender[male 78.8%（119/151）, female 79.50% （35/44）, ）χ2=0. 011 ,P〉O. 05], age group[“15～years old” 82.9%（34/41）, “30～years old” 83.8%（57/68）, “45～years old” 79.2%（38/48）, “60～years old” 65.8%（25/38）,χ2=5. 328,P〉0.05], region[local census register,79.2% （103/130） ,Nonlocal census register 78.5%（51/65）,χ2=0. 015 ,P〉0.05]and patient classification [relapse 77.7% （122/157）, initial treatment failure 84. 6%（11/13）, other retreatment 84.0% （21/25）, χ2= 0. 824, P〉0.05]. Conclusion The drug resistance of retreatment tuberculosis is serious in Beijing. We should strengthen the research on existing treatment methods in TB control in order to meet the evolving needs of capital tuberculosis control under the new situation.

关 键 词：结核 肺 分枝杆菌 结核 抗药性 细菌 北京市 

分 类 号：R521[医药卫生—内科学]