2014-2018年睢阳区肺结核病流行病学分析及病原菌特点  

Epidemiological characteristics of and pathogenic bacteria causing tuberculosis in the Suiyang District in the, City of Shangqiu, Henan Province from 2014 to 2018

作　　者：朱紫叶[1] 方明[2] 张体华[1] 崔化彦 ZHU Zi-ye;FANG Ming;ZHANG Ti-hua;CUI Hua-yan(Department of Preventive Medicine,School of Clinical Medicine,Shangqiu Medical College,Shangqiu,Henan,China 476000;Department of Physiology,Department of Basic Medicine,Shangqiu Medical College,Shangqiu,Henan,China 476000;Suiyang District Center for Disease Control and Prevention,Shangqiu,Henan,China 476000)

机构地区：[1]商丘医学高等专科学校临床医学院预防医学教研室,河南商丘476000 [2]商丘医学高等专科学校基础医学部生理学教研室 [3]商丘市睢阳区疾病预防控制中心

出　　处：《中国病原生物学杂志》2020年第7期823-826,829,共5页Journal of Pathogen Biology

基　　金：2019年度商丘市哲学社会科学规划立项课题。

摘　　要：目的分析2014-2018年河南省商丘市睢阳区肺结核病患者资料,了解该地区结核分枝杆菌的耐药情况,为结核病防控措施的制定提供科学依据。方法统计2014-2018年睢阳区肺结核病报告数据资料,分析肺结核的发病规律,并检测分离菌株对常用抗结核药物的耐药性。结果2014-2018年睢阳区共报告肺结核病4827例,其中新发结核病1362例,呈逐年下降趋势,年均发病率为32.31/10万。新发肺结核患者主要集中在10~75岁,占97.21%。其中16~25岁占26.14%。女性病例数413例,占新发病例数的30.32%;男性949例,占69.68%。职业分布中居前3位的依次为农民、家务待业及学生,其中以农民患者居多,占79.66%。肺结核病一年四季均有发生,但主要集中在3-5月,4月为发病高峰。从300例肺结核患者的痰液标本中分离培养出300株结核分枝杆菌,5种痰液类型中结核杆菌检情况为:粘液痰检出19株,占6.33%;浆液痰25株,占8.33%;干酪样痰69株,占23.00%;脓样痰39株,占13.00%;血样痰148株,占49.33%。300株结核杆菌中有58株菌对常用抗结核药物不同程度耐药,总耐药率为19.33%,其中对氧氟沙星的耐药率为8.00%,乙胺丁醇及卡那霉素耐药率分别为0和0.33%。耐药相关因素分析显示,性别、吸烟、治疗类型、规律服药与肺结核耐药有相关性(均P<0.05)。结论2014-2018年睢阳区肺结核发病率呈缓慢下降趋势,青年、男性、农民及学生为高发人群,是该地区肺结核病的防治重点,且性别、吸烟、治疗类型、规律服药与结核病耐药相关。应制定针对性的防治措施,进一步控制肺结核病疫情。Objective To analyze the data on tuberculosis in the Suiyang District in,the City of Shangqiu,Henan Province from 2014 to 2018,and to ascertain the drug resistance of Mycobacterium tuberculosis in this area in order to provide a scientific basis for the prevention and control of tuberculosis.Methods Statistical data on reports of tuberculosis in the Suiyang Ddistrict from 2014-2018 were analyzed to determine the regularity of outbreaks.The sputum of patients was collected,and M.tuberculosis was isolated and cultured.The proportion method was used to test the drug sensitivity of M.tuberculosis strains to anti-tuberculosis drugs.The clinical data on the patients were collected and verified by two experienced doctors.Factors influencing the drug resistance of M.tuberculosis were compared and analyzed.Results From 2014 to 2018,4,827 cases of tuberculosis were reported in the Suiyang District in the City of Shangqiu,Henan Province.Of them,1,362 cases were newly diagnosed,with an average annual incidence of 32.31/100,000.The incidence of pulmonary tuberculosis in the Suiyang District has tended to decline.New patients with pulmonary tuberculosis were mostly(97.21%)ages 10-75 years.Of those 26.14%were ages 16-25 years.The total number of female patients was 413,accounting for 30.32%of the total incidence.The total number of male patients was 949,accounting for 69.68%of the total incidence.In terms of the patient distribution by occupation,the top three occupations were farmers,housewives,and students.farmers constituted the majority,accounting for 79.66%.Tuberculosis occurs every month but it,mainly occurs in March-May,peaking in April.Three hundred strains of M.tuberculosis were isolated from sputum samples of 300 patients with pulmonary tuberculosis.tuberculosis bacilli were detected in mucous sputum from 19 patients(6.33%),serous sputum from 25(8.33%),caseous sputum from 69(23.00%),pus sputum from 39(13.00%),and serous sputum from 148(49.33%),and the rate of detection of tuberculous bacilli in various forms of sputum

关 键 词：肺结核 流行病学 病原菌 

分 类 号：R52[医药卫生—内科学]