中国6个省份结核分枝杆菌耐药状况及影响因素分析  

Analysis on drug resistance of Mycobacterium tuberculosis and influencing factors in six provinces of China

作　　者：宋艺[1,3] 万李[2,3] 陈双双[3,4] 徐永娟[3,4] 刘志广[3] 赵秀芹[3] 刘海灿[3] 吴移谋[4] 万康林[3,4] 管茶香[2] 刘民[1] 

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,100191 [2]中南大学湘雅医学院生理学系,长沙410000 [3]中国疾病预防控制中心传染病预防控制所 传染病预防控制国家重点实验室传染病诊治协同创新中心,北京102206 [4]南华大学病原生物学研究所,衡阳421000

出　　处：《中华流行病学杂志》2016年第7期945-948,共4页Chinese Journal of Epidemiology

基　　金：国家科技重大专项（2013ZX10003002-001）;中南大学研究生创新基金（2015zzts280）

摘　　要：目的 分析北京、吉林、新疆、陕西、湖南、河南6省份结核分枝杆菌耐药性数据，了解耐药性结核病分布特征及影响因素。方法 在6省份采用问卷调查收集背景资料，并使用比例法药物敏感性试验对4种一线抗结核药物（异烟肼、利福平、链霉素、乙胺丁醇）进行检测，再利用SPSS 20.0软件分析其危险因素。结果 总体耐药率和耐多药率分别为23.42%和13.51%。北京、吉林、湖南、河南、陕西、新疆分离株耐药率分别为21.50%、12.24%、36.27%、42.86%、27.78%、24.39%，耐多药率分别为4.67%、8.16%、24.51%、26.53%、15.28%、14.15%。χ^2检验结果显示，各省份间单种药物耐药率、总体耐药率和耐多药率差异均有统计学意义（P=0.000）。单因素分析结果显示，结核病的复发、治疗史与耐药结核病的产生具有明显的相关性，差异有统计学意义（P〈0.05）。结论 我国耐药结核病的形势非常严峻，调查地区结核病耐药性存在明显差异，应针对各地区主要的危险因素加强预防干预。Objective To analyze the drug-resistance of clinical Mycobacterium tuberculosis strains isolated from the tuberculosis （TB） patients in six provinces in China and related risk factors, and provide evidences for the effective prevention and treatment of drug resistant TB. Methods Six provinces were selected from China. The background information of the TB patients was investigated with questionnaire survey, and the drug susceptibilities of the clinical M. tuberculosis strains to isoniazid, rifampin, ethambutol and streptomycin were tested by means of the proportional drug susceptibility test. Then the results and related risk factors were analyzed with software SPSS 20.0. Results The overall drug resistant rate and multi drug-resistant （MDR） rate were 23.42% and 13.51% respectively. The overall drug resistant rate and MDR rate in Beijing, Jilin, Hunan, Henan, Shaanxi, Xinjiang were 21.50%, 12.24%, 36.27%, 42.86%, 27.78%, 24.39% and 4.67%, 8.16%, 24.51%, 26.53%, 15.28%, 14.15%, respectively. The χ^2 analysis results showed that the differences in single drug-resistant rate, overall drug resistant rate and MDR rate in these provinces had significant differences （P=0.000）. The univariate statistical analysis results showed that the retreatment for TB and TB treatment history were the risk factors associated with drug resistance （P〈0.05）. Conclusion The drug resistance of TB was very serious in China, but the TB drug resistance varied with province. The preventive intervention should be strengthened against all the major risk factors associated with the drug resistance for the better prevention and control of TB.

关 键 词：结核分枝杆菌 耐药结核病 耐多药结核病 危险因素 

分 类 号：R52[医药卫生—内科学]