菏泽市住院结核病患者一线抗结核药品耐药状况分析  

Analysis of resistance to first line anti-tuberculosis drugs of tuberculosis inpatients in Heze

作　　者：孙付胜[1] 皇甫蓓蓓[2] 任惠芹[1] 陈秀英[1] 刘增法 

机构地区：[1]菏泽市疾病预防控制中心结核病防治科,山东菏泽274000 [2]菏泽市传染病医院检验科,山东菏泽274000 [3]山东省卫生教育培训中心出国(境)事务部,山东济南250014

出　　处：《临床肺科杂志》2016年第7期1271-1274,共4页Journal of Clinical Pulmonary Medicine

基　　金：山东省医药卫生科技发展计划(No 2013WS0199)

摘　　要：目的 探讨菏泽市住院结核病患者一线抗结核药品的耐药状况。方法 收集2014年1月1日至2015年4月30日在菏泽市传染病医院住院的结核病患者资料,使用绝对浓度法对异烟肼（H）、利福平（R）、链霉素（S）、乙胺丁醇（E）进行药物敏感性检测,并分析耐药状况。结果 259例患者中,98例患者耐药,总体耐药率为37.84%,其中单耐药率25.10%,多耐药率6.56%,耐多药率6.18%;4种药物的耐药率由高到低依次为S（31.66%）、H（12.36%）、R（10.42%）、E（2.32%）;男性、女性患者的耐药率分别为40.85%和23.91%,差异有统计学意义（〈0.05）,≤30岁、31-45、46-60、≥61岁组患者的耐药率分别为29.03%、39.13%、55.00%、31.87%,差异有统计学意义（〈0.05）,初治患者耐药率为30.46%,复治患者为61.29%,差异有统计学意义（〈0.05）;单耐药以耐S最多,多耐药以耐HS最多,耐多药以耐HRS最多。结论 菏泽市的结核病患者对一线抗结核药品的耐药总体上并不严重,但对中老年男性患者以及复治患者的耐药风险应高度重视,在对患者的治疗中应合理使用S和H。Objective To discuss the resistance to first line anti-tuberculosis drugs of tuberculosis inpatients in Heze. Methods The data of positive sputum culture TB inpatients in Heze Infectious Disease Hospital from January 1st 2014 to April 30th 2015 were collected to analyze the results of drug sensitive to isoniazid （H）, rifampin （R）, streptomycin （S） and ethambutol （E） by absolute concentration method. Results 98 of them were drug resistant, and the total drug resistance rate was 37.84%. The mono-drug resistance rate was 25.10% , the poly-drug resistance rate was 6. 56% , and the multi-drug resistance rate was 6. 18%. The drug resistance rate of the 4 drugs that from high to low was S （31.66%）, H （ 12. 36% ）, R （ 10.42% ） and E （2. 32% ）. The drug resistance rates of male and female were 40. 85% and 23.91% respectively （P 〈0. 05）. The rates of patients that younger than 30 years old, from 31 to 45 years old, from 46 to 60 years old, older than 61 years old were 29. 03%, 39. 13%, 55.00% and 31.87% respectively（ P 〈 0. 05 ）. The rate of the first-treatment patients was 30. 46%, which of the retreatment patients was 61.29% （P 〈 0.05 ）. S was the most mono-drug resistant drug, HS was the most combination of poly-drug resistance, and HRS was the most combination of multi-drug resistance. Conclusion In Heze, the drug resistance of tuberculosis patients to first line anti-tuberculosis drugs is not serious in general. However, we should pay great attention to the risk of drug resistance in senile male patients and re-treatment patients, and the rational use of S and H.

关 键 词：结核病 痰培养阳性 耐药 菏泽 

分 类 号：R52[医药卫生—内科学]