耐药结核病流行状况调查分析  

Prevalence survey and analysis of drug-resistant tuberculosis

作　　者：郑春秀[1] 崔振玲[2] 

机构地区：[1]中国人民武装警察部队总医院,北京100039 [2]同济大学附属肺科医院,上海200433

出　　处：《检验医学与临床》2014年第9期1156-1158,共3页Laboratory Medicine and Clinic

基　　金：高等学校博士学科点专项科研基金资助项目(20090072120049)

摘　　要：目的探讨耐药结核病的流行状况,为耐药结核病的防治提供有效的科学依据。方法 2012年3月至2013年3月于北京市设立各个监测点,再由相关医院确诊痰涂片检测为阳性的肺结核患者中,抽样选取164例作为研究对象,进行药敏检测与数据统计。结果结核病患者对一线药物的耐药率,如异烟肼(INH)、链霉素(SM)、利福平(RFP)、乙胺丁醇(EMB)等,其初治组患者明显低于复治组患者,差异有统计学意义(P<0.05);但是结核病初治组患者仅对INH、RFP、SM和INH、RFP、SM、EMB两种治疗方案耐药,其初、复治组患者对3种治疗方案耐多药率相比差异有统计学意义(P<0.05)。初治组患者对SM的耐药率(23.86%)最高,而复治组患者对INH的耐药最高(42.11%),两组比较差异有统计学意义(χ2=5.38,P<0.05)。结论北京市结核病的耐药状况需有针对性的对相关问题进行改善,方能对耐药结核病的流行起到抑制作用。Objective To study the prevalence of drug-resistant tuberculosis and to provide effective and scien-tific basis for prevention and control of drug-resistant tuberculosis .Methods Monitoring-stations were set up in counties and districts of certain city between March 2012 and March 2013 .A total of 164 pulmonary tuberculosis pa-tients ,whose sputum smears were with positive diagnosis ,were selected as research objects by random sampling for drug susceptibility test and data analysis .Results Drug-resistant rate to first-line drugs ,such as isonicotinyl hydra-zide（INH） ,rifampicin（RFP） ,ethambutol（EMB） and streptomycin（SM ） ,of tuberculosis patients with initial treat-ment was significantly lower than that of patients with re-treatment（P〈0 .05） .But only two kinds of multi-drug re-sistance were identified ,including resistance to INH ,RFP ,EMB ,and resistance to INH ,RFP ,SM ,EMB ,and the multi-drug resistance rates were with significant difference between patients with initial treatment and patients with re-treatment（P〈0 .05） .Drug- resistance rate of tuberculosis patients with initial treatment to SM was the highest （23 .86% ） ,but of patients with re-treatment ,resistance rate to INH was the highest（42 .11% ） ,and there was signifi-cant difference between the two groups（χ2 =5 .38 ,P〈0 .05） .Conclusion The status of drug resistance of tuberculo-sis in this city should be targeted improved to inhibit the prevalence of drug-resistant tuberculosis .

关 键 词：结核病 耐药 痰涂片 药敏检测 

分 类 号：R52[医药卫生—内科学]