西安市全球基金耐多药结核病项目实施两年效果分析  

Analysis on implementation effect of the global fund of multidrug resistant tuberculosis project in Xi'an

作　　者：王艳飞[1] 张慧[1] 曾令城[1] 柳巍[1] 刘军叶[1] 

机构地区：[1]西安市疾病预防控制中心,陕西西安710054

出　　处：《现代预防医学》2017年第6期1056-1059,共4页Modern Preventive Medicine

基　　金：国家自然科学基金项目资助(项目编号:81272490);陕西省社会发展科技攻关项目资助(项目编号:2015SF092)

摘　　要：目的分析西安市全球基金耐多药结核病项目实施效果,为今后制定耐多药结核病控制策略提供依据。方法对项目执行期间的报表、实验室登记本、患者病案和追访信息等进行分析。结果截至2014年6月底,共登记耐多药结核病可疑者554例,554例均进行痰培养,培养结果阳性356例(64.26%),对292例培养结果阳性者行药敏实验,共确诊101例耐多药结核病患者,其中新患者耐多药检出率16.18%,不同患者分类的耐多药检出率差异有统计学意义(χ~2=13.54,P<0.01)。52例确诊患者纳入"项目",纳入率51.49%;项目组治疗成功率55.77%,非项目组治疗成功率22.45%,差异有统计学意义(χ~2=11.71,P<0.01);项目组患者6月末痰涂片阴转率60.78%,痰培养阴转率54.90%,12月末痰涂片阴转率65.31%,痰培养阴转率63.27%。结论耐多药高危人群筛查策略、定点医院治疗和疾控中心管理的防治模式是可行和高效的,项目实施为西安市耐多药防治打下了基础,为今后的工作提供了指导和借鉴。Objective To evaluate the implementation effect of the multidrug resistant tuberculosis （MDR-TB） project in Xi＇au, and to provide evidence for the future development of MDR-TB control strategy. Methods The project reports, laboratory records, MDR-TB patient medical records and other data during the implementation of the MDR-TB project were systematically analyzed. Results By the end of June 2014, a total of 554 cases of suspected MDR-TB were reported, and sputum culture was carried out to each case. 356 cases （64.26%） were positive incuhure.and among them 292 cases were tested fordrug sensitivity, with 101 cases confirmed to be drug-resistant TB, with an detection rate of 16.18% and statistically significant difference （χ^2=13.54, P〈0.01）. The rate of successful treatment in the project group was 55.77% and 22.45% in the non-project group, with statistically significant difference （χ^2=11.71, P 〈0.01）. By the end of June sputum smear-negative rate was 60.78% and sputum culture negative rate was 54.90%. By the end of December sputum smear-negative rate was 65.31%, and sputum culture negative rate was 63.27%. Conclusion It is feasible and effective to prevent and control MDR-TB by combining high risk populationscreening, treatment in the designated hospitals and CDC management. The implementation of the project has laid a foundation for MDR-TBprevention and control in Xi＇an, and provided guidance and reference for future work.

关 键 词：结核 肺 耐多药 预防和控制 治疗结果 

分 类 号：R521[医药卫生—内科学]