浙江省江山市626例肺结核患者耐药情况分析  

Drug resistance analysis on 626 cases of pulmonary tuberculosis in Jiangshan City,Zhejiang Province

作　　者：王伟华[1] 郑逸华[1] 林雪梅[1] 毛晓敏[1] 林彩侠 WANG Wei-hua;ZHENG Yi-hua;LIN Xue-mei;MAO Xiao-min;LIN Cai-xia(The People's Hospital of Jiangshan,Quzhou,Zhejiang 324100,China)

机构地区：[1]江山市人民医院

出　　处：《上海预防医学》2018年第11期965-968,共4页Shanghai Journal of Preventive Medicine

摘　　要：【目的】观察肺结核耐药情况,为临床制定化疗方案提供科学依据。【方法】回顾性分析2011年1月至2015年7月于江山市医院就诊的肺结核患者资料病例,并对6种抗结核药物的耐药性进行测试。【结果】本次研究共纳入有药敏结果的患者626例,其中初治584例,复治42例;165例患者耐药,总耐药率为26.4%,单耐药率为15.7%,多耐药率为5.3%,耐多药为5.4%。初治患者总耐药率为24.5%,单耐药率为15.9%,多耐药率为5.1%,耐多药为3.4%。复治患者的总耐药率为52.4%,单耐药率为11.9%,多耐药率为7.1%,耐多药率为33.3%。初治患者和复治患者耐药率分别是异烟肼(INH)13.7%、42.9%;利福平(RFP)4.3%、33.3%;乙胺丁醇(EMB)2.7%、7.1%;链霉素(SM)13.4%、33.3%;氧氟沙星6.2%、19.0%;卡那霉素(KM)2.9%、11.9%。【结论】江山市肺结核复治患者的耐药率高,尤其是耐多药率高。初治患者对异烟肼、链霉素的耐药性较高,初、复治患者均对乙胺丁醇耐药率低。应根据本地区耐药性检测情况合理使用抗结核药物,提高疗效,并加强综合管理。[Objective]To investigate the drug resistance of pulmonary tuberculosis and provide scientific basis for clinical formulation of chemotherapy regimens.[Methods]A retrospective analysis of cases of tuberculosis in hospitals in Jiangshan City from January2011to July2015was conducted to test the resistance of six anti-TB drugs.[Results]A total of626patients with drug sensitivity were included in this study,of whom584were initially treated and42retreated;165were drug resistant;the total drug resistance rate was26.4%,the monoresistance rate15.7%,polyresistance rate5.3%and multidrug resistance rate5.4%.The total resistance rate in the newly diagnosed patients was24.5%.The monoresistance rate was15.9%,polyresistance rate5.1%,and multidrug resistance rate3.4%.The total drug resistance rate in retreated patients was52.4%,monoresistance rate11.9%,polyresistance rate7.1%,and multidrug resistance rate33.3%.The resistance rates of newly diagnosed patients and retreated patients were isoniazid(INH)13.7%,42.9%;rifampicin(RFP)4.3%,33.3%;ethambutol(EMB)2.7%,7.1%;Strain(SM)13.4%,33.3%;Ofloxacin6.2%,19.0%;Kanamycin(KM)2.9%,11.9%.[Conclusion]The resistance rate in retreated pulmonary tuberculosis patients in Jiangshan is high,especially the multidrug resistance rate.The newly-treated patients has higher resistance to isoniazid and streptomycin,and the initially treated and retreated patients prove to have lower resistance to ethambutol.Rational use of anti-tuberculosis drugs should be based on the detection of drug resistance in the local region so as to improve efficacy and strengthen integrated managementoftuberculosis.

关 键 词：初治 复治 肺结核 耐药 

分 类 号：R52[医药卫生—内科学]