2009—2014年宜昌市菌阳肺结核一线抗结核药物耐药性分析  

Analysis on the resistance of the first-line anti-tuberculosis drugs of positive pulmonary tuberculosis in Yichang City(2009—2014)

作　　者：袁凤花[1] 张培[1] 刘晓俊[1] 周萍[1] 余云芳[1] 方正超[1] 

机构地区：[1]湖北省宜昌市疾病预防控制中心,湖北宜昌44300

出　　处：《公共卫生与预防医学》2016年第1期40-43,共4页Journal of Public Health and Preventive Medicine

基　　金：中国国家卫生和计划生育委员会-比尔及梅琳达盖茨基金会结核病防治合作项目(51914)

摘　　要：目的了解2009—2014年宜昌市菌阳肺结核患者一线抗结核药物耐药性情况,为制定耐药肺结核防治策略提供依据。方法收集2009—2014年痰培养阳性及痰涂片阳性患者的一线抗结核药物敏感性实验结果等资料,进行统计分析。结果1总耐药率20.77%,耐R率12.72%,MDR率8.94%;2耐药模式包括耐单物、耐两种药物、耐三种药物、耐四种药物的一线药物各种组合,其中以MDR类型为主;2009—2014年,菌阳肺结核患者的总耐药率、耐R率、MDR率、耐H率、耐E率、耐S率均明显下降;3男性患者的总耐药率、耐R率、MDR率与女性患者无明显差异;随着年龄的增长,男性和女性菌阳肺结核患者的总耐药率、耐R率、MDR率均有先增高再降低的趋势;4复治菌阳患者总耐药率、耐R率和MDR率明显高于初治菌阳患者;5宜昌市城区总耐药率、耐R率和MDR率均最高,以耐R率和MDR率明显高于其他县市。结论宜昌市菌阳肺结核患者耐药水平较2009年有所下降,但仍处于较高水平,需要可持续的耐药防治工作策略来进一步降低耐药肺结核疫情,需建立起政府主导、多部门协作的长效工作机制。Objective To understand the first-line anti-tuberculosis drug resistance of positive pulmonary tuberculosis in Yichang City from 2009 to 2014,and provide the basis for the strategies of drug resistant tuberculosis prevention and control. Methods The results of the first-line anti-tuberculosis drug sensitivity test of positive pulmonary tuberculosis from 2009 to 2014 were collected and analyzed. Results 1. Total drug resistance rate was 20. 77%; the resistant rate of rifampicin was 12. 72%; multi drug resistant rate was 8. 94%. 2. The drug resistance pattern included a combination of drugs,two drugs,three drugs,four kinds of first-line drugs,among which MDR was the main type. From 2009 to 2014,the total drug resistance rate,rifampicin resistant rate,multi drug resistant rate,isoniazid resistant rate,ethambutol resistant rate,and streptomycin resistant rate significantly decreased. 3. Total drug resistance rate,the resistant rate of rifampicin and multi drug resistant rate had no difference between male and female patients. With the increase of age,the total drug resistance rate,rifampicin resistant rate and multi drug resistant increase. The rate of the male and female positive pulmonary tuberculosis patients decreased after the first increase. 4. The total drug resistance rate,rifampicin resistant rate and multi drug resistant rate of the retreatment positive patients were significantly higher than those of the initial treated patients. 5. The total drug resistance rate,rifampicin resistant rate and multi drug resistant rate in Yichang town were the highest,especially the rifampicin resistant rate and multi drug resistant rate. Conclusion The level of drug resistance in the positive pulmonary tuberculosis patients in Yichang city was lower than that in 2009,but still at a high level. Therefore,the sustainable strategies for drug resistant tuberculosis prevention and control to further reduce the drug resistant tuberculosis epidemic is necessary. It is also necessary to establish a government led,multi sectoral co

关 键 词：肺结核 耐药 一线抗结核药物 

分 类 号：R521[医药卫生—内科学]