嘉兴市老年人群肺结核耐药菌群分布及危险因素分析  

Analysis on drug resistance of tuberculosis mycobacteria among elder patients with TB in Jiaxing

作　　者：胡洁[1] 罗建勇 徐文贤[1] HU Jie LUO Jian yong XU Wen-xian(Jiaxing Center for Disease Control and Preuention , Jiaxing, Zhejiang 314050 , China)

机构地区：[1]嘉兴市疾病预防控制中心,浙江嘉兴314050

出　　处：《中国预防医学杂志》2017年第9期667-670,共4页Chinese Preventive Medicine

基　　金：嘉兴市科技局资助项目(2014AY21036-2)

摘　　要：目的对嘉兴市老年人群肺结核患者的临床资料进行分析,探讨老年肺结核患者耐药菌群分布情况及耐药性的危险因素探析。方法 2013年1月至2016年3月,收集536例在嘉兴市各结核病定点诊治机构进行诊治的痰结核分枝杆菌培养阳性患者的临床资料,年龄≥60岁。结果 536例结核分枝杆菌阳性中,总耐药率为14.18%,仅1种药物耐药者构成比最高,占61.84%(47例),其次为耐2种及3种药物者,耐4种药物者较少,仅为2例,占2.63%,差异有统计学意义。异烟肼耐药率为10.07%,依次为链霉素耐药率6.34%,利福平耐药率3.17%,乙胺丁醇耐药率1.49%,差异有统计学意义。涂片阳性、影像学显示,有空洞以及有过治疗史是老年人群肺结核产生耐药性的危险因素,差异有统计学意义(P<0.05),性别、居住地区等因素差异无统计学意义(P>0.05)。结论老年人口是结核病发病的重点人群,且以单独一种药物耐药及耐异烟肼药物者居多,同时其产生耐药与涂片情况、有无空洞以及治疗史密切相关,临床上应规范使用药物,避免或延缓结核菌耐药性的产生。Objective To discuss the distribution and risk factors of drug resistant tuberculosis mycobacteria in elder patients in Jiaxing. Methods Clinical data of 536 TB patients aged 60 years and above with sputum culture positive diagnosed and treated in medical institutions in Jiaxing were collected. Results The overall drug resistance rate was 14.18% and majority（61.84%）were single drug resistant.Only 2.63% were resistant to 4drugs.The drug resistance rate was highest of 10.07% to isoniazid,followed by 6.34% to streptomycin,3.17% to ethambutol and 1.49% to rifampin,the differences were significant.Positive sputum smear,cavities in lung images and treatment history were risk factors of drug resistance of bacteria among elder patients with TB（P〉0.05）,while gender and residential area were not related with drug resistance（P〈0.05）. Conclusions The elder population is more vulnerable to TB bacteria which is usually resistant to one drug and isoniazid is the most common one.Smear positive,cavities in lung image and treatment history are related to drug resistance.Standardized use of drugs is critical in avoiding and delaying drug resistance of tuberculosis mycobacteria.

关 键 词：老年人群 结核 肺 耐药性 危险因素 菌群 分布情况 分枝杆菌 

分 类 号：R521[医药卫生—内科学]