2271例结核病患者耐药情况的流行病学特征分析  

Drug resistance situation in 2 271 tuberculous patients and epidemiological characteristics analysis

作　　者：程曦[1] 李亚斐[2] 饶英[3] 杨小红[3] 杜鸿[3] 

机构地区：[1]第三军医大学军事预防医学院,重庆400038 [2]第三军医大学军队流行病学教研室,重庆400038 [3]重庆市中山医院,重庆400020

出　　处：《重庆医学》2015年第12期1635-1637,共3页Chongqing medicine

摘　　要：目的探讨结核病患者耐药情况和流行病学特征,为结核病的有效预防和合理治疗提供参考依据。方法对2009年1月至2013年12月重庆市中山医院江北院区收治的2 271例痰涂片阳性肺结核患者进行10种抗结核药物(异烟肼、链霉素、利福平、乙胺丁醇、对氨柳酸钠盐、卡那霉素、力克肺疾、丙硫异烟胺、卷曲霉素、氧氟沙星)的耐药性检测,分析其药敏结果。结果2 271例痰培养阳性肺结核病例中,总耐药率和总耐多药率分别为61.91%和26.29%;初、复治患者的总耐药率分别为52.85%和78.06%,耐多药率分别为16.70%和43.38%;平均耐药率顺位前5位由高到低为链霉素(39.45%)、异烟肼(33.20%)、利福平(32.94%)、对氨柳酸钠盐(31.40%)、力克肺疾(21.53%);抗结核治疗史、性别、年龄和职业与耐药发生有显著关联(P<0.05)。结论重庆局部地区近5年结核病患者结核病耐药形势严峻,应加强耐药结核患者的规范管理和治疗。Objective To investigate the drug resistance situation and the epidemiological characteristics in the tuberculous patients in order to provide the reference for effective prevention and treatment of TB. Methods Totally 2 271 patients with posi- tive sputum smear pulmonary tuberculosis（TB） in the Jiangbei Branch Hospital of Chongqing Zhongshan Hospital from January 2009 to December 2013 were performed the drug resistance detection of 10 kinds of anti-TB drugs（isoniazid,streptomycin,rifampi- cin, ethambutol, para-aminosailcylic acid, kanamycin, pasiniazid, protionamide, capreomycin, and ofloxacin）. Results Of all 2 271 ca- ses of positive sputum culture pulmonary TB,the total drug resistance rate and total multi-drug resistance rate were 61.91% and 26.29 %, respectively; the total drug resistance rates in initial treatment and retreatment patients were 52.85% and 78.06 % respec- tively,and the multi-drug resistance rates were 16.70 % and 43.38 %, respectively; the top five in the average drug resistance rates from high to low were streptomycin（39.45%）, isoniazid（33.20%）, rifampicin（32.94%）, para-aminosaileylic aeid（31.40%） and pasiniazid（21.53%）;the anti-TB treatment history, gender, age and occupation were significantly associated with the drug resist- ance occurrenee （P〈0.05）. Conclusion The drug resistance situation of the TB patients in the local area of Chongqing is serious in the recent 5 years. The standardized management and treatment on the TB patients with drug resistance should be strengthened.

关 键 词：结核 肺 广泛耐药结核 流行病学 影响因素 

分 类 号：R521[医药卫生—内科学] R181.35[医药卫生—临床医学]