耐多药肺结核流行现状分析  

Epidemiological status of multidrug-resistant tuberculosis

作　　者：谭明伟[1] 刘晞照[1] 郭晓华[1] 饶俊莉[1] 李兴挺[1] 熊德场[1] 

机构地区：[1]重庆三峡中心医院感染管理科,重庆404000

出　　处：《中华医院感染学杂志》2014年第17期4292-4294,共3页Chinese Journal of Nosocomiology

基　　金：国家科技重大专项基金项目(2008ZX10003-007)

摘　　要：目的了解重庆地区耐多药肺结核流行现状,为进一步调整筛查策略及有效预防控制疫情扩散提供参考依据。方法调查收集2010年3月-2012年2月定点医院收治来自渝东北7个区县的耐多药肺结核病例资料,分析其发病情况和流行特征;采用SPSS19.0软件进行统计分析。结果 2010年3月-2012年2月共调查涂片阳性耐多药肺结核可疑者554例,检出耐多药肺结核患者37例,其中2例诊断为广泛耐药肺结核,涂阳肺结核患者耐多药率为6.68%,耐多药患者主要来自万州区,城乡差异无统计学意义,患者平均年龄(43.57±2.65)岁,男女性别比为2.36∶1,耐多药患者病死率21.62%;6类高危人群的MDR-TB检出率为24.51%;肺结核涂阳患者中初治耐多药率为3.04%,复治耐多药率为24.47%;7类不同涂阳患者类型中耐多药率最高的为复治失败患者,达66.67%。结论重庆地区耐多药肺结核发病水平与全国相当,有年轻化趋势,病情较重、病死率较高,复治失败患者是耐多药结核的高危人群;当前筛查策略趋于合理,仍需完善。OBJECTIVE To understand the epidemiological status of multidrug-resistant tuberculosis in Chongqing,ng area so as to further adjust the screening strategies and control the spread of the epidemic. METIIODS The medical records were collected from the patients with multidrug-resistant tuberculosis who were treated in the appointed hospitals from Mar 2010 to Feb 2012, then the incidence of disease and epidemiological characteristics were analyzed, and the statistical analysis was performed with the use of SPSS19. 0 software. RESULTS Of 554 patients with suspected multidrug-resistant tuberculosis who were positive for smear from Mar 2010 to Feb 2012, 37 were confirmed with muhidrug-resistant tuberculosis, including 2 cases of pandrug-resistant tuberculosis, the multidrug-resistant rate of the tuberculosis patients with positive smear was 6.68%, and most of the patients with multidrug-resistant tuberculosis came from Wanzhou area, there was no significant difference between the rural and urban area. The average age of the patients was （43.57±2.65） years old, the ratio of the male and female was 2. 36 , 1, and the mortality rate of the patients with multidrug-resistant tuberculosis was 21.62%. The detection rate of multidrug-resistant tuberculosis was 24.51% in 6 highly-risk populations. The multidrug-resistant rate of the tuberculosis patients with positive smear was 3.04% in the primary treatment, 24.47% in the retreatment. Among the patients with 7 types of positive smears, the multidrug-resistant rate was the highest （66.67%） in the patients who failed the retreatment. CONCLUSION The incidence of multidrug-resistant tuberculosis is as comparable in Chongqing area as in the whole country and tends to increase in the young population, the condition is severe, the mortality rate is high, and the patients who fail the retreatment are the population at high risk of multidrug-resistant tuberculosis. The screening strategies tend to be reasonable and still need to be improved.

关 键 词：耐多药肺结核 流行现况 筛查策略 疫情控制 

分 类 号：R521[医药卫生—内科学]