顺德地区肺结核病耐药情况分析  

Analysis of TB drug resistance in Shunde district

作　　者：欧阳国栋[1] 蔡冰[1] 吴渊[1] 

机构地区：[1]佛山市顺德区慢性病防治中心,广东佛山528300

出　　处：《临床肺科杂志》2015年第8期1502-1505,共4页Journal of Clinical Pulmonary Medicine

基　　金：佛山市医学类科技攻关项目(No 2014AB001603)

摘　　要：目的分析顺德地区肺结核病耐药情况,为制定下一阶段肺结核防治计划提供科学依据。方法选取2014年1月至2014年11月新增涂阳肺结核患者399例,在此过程中复治患者有71例,对就诊患者中疑似感染人员留取夜间痰、清晨痰和即时痰三份标本进行抗酸杆菌涂片检查和培养,培养阳性标本进行菌种鉴定,对结核分枝杆菌进行异烟肼(H)、链霉素(S)、利福平(R)、乙胺丁醇(E)、左氧氟沙星(LFX)、卡那霉素(KM)、对氨基水杨酸(PAS)7种一、二线药物敏感试验。收集患者初治、复治过程中耐药种类、耐药程度,与性别、年龄、治疗类型间的关系等数据,并进行统计学分析。结果无论在初治患者还是复治患者中R、S、H、E均为患者主要耐受性药物,两组单种耐药性比较数据差异不明显,不具有统计学意义(P>0.05)。复治患者较初治患者耐多种药物水平有所增加,两组数据比较,差异明显,具有统计学意义(P<0.05)。治疗类型和年龄能够影响患者多种药物耐受性,复治和老年患者中多种药物耐受性增加。结论顺德地区耐药和耐多药肺结核防止和控制工作仍不能忽视,应加强宣传教育和管理,以期降低耐药性。Objective To analyze the TB drug resistance in Shunde District in order to provide a scientific basis for the development of the next stage of tuberculosis control programs. Methods 399 tuberculosis patients were selected from January, 2014 to November, 2014, including 71 retreated patients. Their sputum specimens were collected at night, in the early morning and instantly to be cultured and given acid-fast bacillus smear examination. And then they were given sensitivity test, including isoniazid （ H）, streptomycin （ S）, rifampicin （ R）, ethambutol （ E）, levofloxacin （LFX）, kanamycin （KM） and p-amino salicylic acid （PAS）. The type and degree of drug resistance, gender, age, and type of treatment were analyzed statistically. Results R, S, H and E were the main tolerable drugs for all patients, and there was no significant difference between two single drugs （ P 〉 0. 05 ）. The resistance to multiple drugs was more serious in re-treated patients than in initial-treated patients （P 〈 0.05 ）, and it could be in- fluenced by treatment type and age. Conclusion The work of multi-drug resistant tuberculosis prevention and control can not be ignored, and the communication and management of TB drug resistance should be strengthened.

关 键 词：顺德地区 肺结核 药物敏感试验 耐药性 

分 类 号：R521[医药卫生—内科学]