深圳市2012—2016年流动人口耐多药结核病患者发现及治疗情况  

Detection and treatment of multidrug-resistant tuberculosis in migrating population in Shenzhen, 2012-2016

作　　者：车晓玲[1] 吴清芳[1] 李明珍[1] 管红云[1] 谭卫国[1] CHE Xiaoling;WU Qingfang;LI Mingzhen;GUAN Hongyun;TAN Weiguo(Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong 518020, China)

机构地区：[1]深圳市慢性病防治中心,广东深圳518020

出　　处：《中国热带医学》2018年第6期543-546,554,共5页China Tropical Medicine

基　　金：中国全球基金耐多药结核病防治项目(No.CHN-506-G08-T);深圳市卫生计生系统科研项目(No.201506069)

摘　　要：目的分析深圳市2012年1月—2016年12月5年间流动人口耐多药结核病患者的管治情况,以期为调整深圳市的耐多药结核病综合防控策略提供依据。方法收集深圳市在此期间登记的流动人口耐多药结核病患者的纳入治疗情况、6月末痰菌阴转情况及治疗转归情况等资料,计算耐多药结核病患者的纳入治疗率、6月末痰涂片及痰培养阴转率、成功治疗率。结果 5年间深圳市共检出确诊耐多药结核病患者487例,其中流动人口耐多药结核病患者451例(92.6%);纳入项目进行治疗的流动人口耐多药结核病患者220例(48.8%);未纳入治疗的231例患者中,返乡102例(44.2%);纳入治疗的患者中,完成前6个月治疗的患者203例,6月末痰涂片阴性173例(85.2%)、痰培养阴性175例(86.2%);完成两年治疗的患者190例,治愈111例,完成治疗19例,成功治疗率68.4%。结论由于采用了综合防控措施,流动人口耐多药结核病患者的治疗取得了较好的效果。但是确诊患者的纳入治疗情况却不甚理想,有存在疫情进一步蔓延的危险。下一步工作还需要继续探索改进现有耐多药结核病控制策略,加大对流动人口耐多药结核病患者的纳入治疗力度,防止深圳市耐多药结核病疫情进一步蔓延。Objective To analyze the governance of the migrating population with multidrug-resistant tuberculosis （MDR-TB） from January 2012 to December 2016 in order to provide the evidence for adjusting the comprehensive prevention and control strategy of MDR-TB in Shenzhen City. Methods The data of involvement, sputum conversion at the end of 6 months, and outcomes of treatment of the patients with MDR-TB in the migrating population registered in Shenzhen City were collected from January 2012 to December 2016, and then the rates of treatment,sputum smear conversion, sputum culture conversion, and recovery were calculated. Results During the 5 years, 487 patients with MDR-TB were diagnosed from the whole population, among which 451 cases （92.6%） were from the migrating population. Totally 220 patients from the migrating population were included in the treatment （48.8%）, while 231 patients were not included and 102 of them left Shenzhen City to their hometowns （44.2%）. Of the patients who were included in the treatment, 203 were treated in the first 6 months, and 173 of them were sputum smear negative at the end of the 6 months＇ treatment （85.2%）, while 175 of them were sputum culture negative at the end of the 6 months＇ treatment （86.2%）. The number of the patients who completed the 2 years＇ treatment was 190, and among them, 111 were recovered and 19 completed the treatment, with the successful treatment rate of 68.4%. Conclusions Because of the comprehensive prevention and control measures, the treatment of patients with MDR-TB in the migrating population has been improved. However, the treatment of the diagnosed patients is not ideal, and there is a risk of further spread of the disease. The next step is to continue exploring the improvement of the existing MDR-TB control strategy, and the efforts to include the migrant patients with MDR-TB in the treatment should be strengthened in order to prevent the spread of MDR-TB in the city.

关 键 词：耐多药 肺结核 疾病管理 治疗 

分 类 号：R521[医药卫生—内科学]