佛山市顺德区肺结核耐抗结核药物分析  

Anti-Tuberculosis Drug Resistance in Shunde District of Foshan City

作　　者：吴渊[1] 廖雁[1] 欧阳国栋[1] 黄英河[1] 陈榕[1] 

机构地区：[1]佛山市顺德区慢性病防治中心结核病防治科,广东佛山528300

出　　处：《实用临床医学（江西）》2016年第2期87-89,共3页Practical Clinical Medicine

基　　金：佛山市医学类科技攻关项目(2014AB001603)

摘　　要：目的对佛山市顺德区肺结核患者耐抗结核药物的情况进行分析,为该地区开展结核病防治工作提供参考。方法收集397例涂阳肺结核患者(初治325例,复治72例)的痰标本,对分离培养获得的397株结核分枝杆菌采用浓度比例法对7种一、二线抗结核药物(包括异烟肼、利福平、乙胺丁醇和链霉素、左氧氟沙星、卡那霉素、对氨基水杨酸)进行药物敏感性试验。结果 397例患者耐药112例,耐药率为28.2%,其中链霉素和异烟肼耐药率最高,分别为20.4%(81/397)和12.6%(50/397);耐多药15例,耐多药率为3.8%。初治患者耐药率为26.2%(85/325),复治耐药率为37.5%(27/72),二者比较差异有统计学意义(χ2=5.963,P<0.05);初治耐多药率为1.8%(6/325),复治耐多药率为15.3%(11/72),二者比较差异有统计学意义(χ2=32.586,P<0.05)。结论佛山市顺德区肺结核患者耐药情况比较严重。临床治疗应根据药物敏感性试验结果选择合适药物组成有效治疗方案,以保障治疗效果,达到高治愈率的目标。Objective To analyze the status of anti-tuberculosis drug resistance in Shundedistrict of Foshan city,and to provide a reference for the prevention and treatment of tuberculosis.Methods The resistance of Mycobacterium tuberculosis to seven first-line and second-line antituberculosis drugs（isoniazid,rifampicin,ethambutol,streptomycin,levofloxacin,kanamycin,and para-aminosalicylic acid）wastested in 397 strains of Mycobacterium tuberculosis isolated from sputum specimensof 397smear-positive pulmonary tuberculosis patients（325initial treatment cases and 72 cases of retreatment cases）using proportion method.Results Among the 397 cases,drug resistance occurred in 112（28.2%）,and multi-drug resistance in 15（3.8%）.The highest rate of resistancewas 20.4%（81/397）to streptomycin,followed by 12.6%（50/397）to isoniazid.In addition,the rates of drug resistance and multi-drug resistanceamong initial treatment cases（26.2% and1.8%,respectively）were respectively lower than those among retreatment cases（37.5% and15.3%,respectively）（χ2=5.963andχ2=32.586,respectively;P〈0.05）.Conclusion The situation ofanti-tuberculosis drug resistance is serious in Shundedistrict of Foshan city.Therefore,antituberculosis drugsshould beappropriatelychosen according to drug sensitivity test resultsto ensure the treatment and to improve the cure rate.

关 键 词：肺结核 结核分枝杆菌 药物敏感性试验 耐药性 

分 类 号：R521[医药卫生—内科学]