河南地区HIV/TB合并感染患者结核分枝杆菌初始耐药分析  

Initial drug resistance of mycobacterium tuberculosis in HIV patients with tuberculosis in Henan

作　　者：陈媛媛[1] 刘旭辉[1] 王延丽 侯明杰[1] 王章云 原海珍[1] 辛宁波 赵清霞[1] CHEN Yuanyuan;LIU Xuhui;WANG Yanli;HOU Mingjie;WANG Zhangyun;YUAN Haizhen;XIN Ningbo;ZHAO Qingxia(The No.Sixth People’s Hospital of Zhengzhou City,Zhengzhou 450015,China)

机构地区：[1]郑州市第六人民医院,郑州450015

出　　处：《中国艾滋病性病》2021年第1期14-16,共3页Chinese Journal of Aids & STD

基　　金：国家“十三五”科技重大专项(2017ZX10202101-001-010);河南省科技攻关项目(152102310177)。

摘　　要：目的了解河南地区艾滋病病毒(HIV)感染合并结核病患者结核分枝杆菌初始耐药的情况。方法选取郑州市第六人民医院2015年1月至2019年4月收治的HIV感染合并初治结核病患者80例和非HIV感染初治结核病患者163例,结核病患者的分枝杆菌培养菌型鉴定结果为结核分枝杆菌复合群,并进行药敏试验和试验结果分析。结果对一线抗结核药物初始耐药率,HIV感染合并结核病组患者异烟肼和利福平各占21.3%(17/80),非HIV感染结核病组患者链霉素占11.7%(19/163)。对一线抗结核药物总的初始耐药率分别为25.0%(20/80)和17.2%(28/163),差异无统计学意义(P>0.05)。初始耐多药发生率,HIV感染合并结核病组为18.8%(15/80),非HIV感染结核病组为6.7%(11/163),差异有统计学意义(P<0.05)。HIV感染合并结核病组有1例广泛耐药患者占1.3%(1/80)。对二线抗结核药物总的初始耐药率差异无统计学意义(P>0.05)。结论河南地区HIV感染合并结核病患者初始耐药中耐异烟肼、利福平比例最高,耐多药发生率比非HIV感染结核病组患者高;并出现了广泛耐药结核病患者。Objective To understand the initial drug resistance of anti-tuberculosis drugs among HIV patients with tuberculosis in Henan.Methods The data of 80 cases of HIV infection with initial treatment of tuberculosis and 163 cases of non-HIV initial treatment of tuberculosis were collected in the Sixth People’s Hospital of Zhengzhou from January 2015 to April 2019.These patients were diagnosed with tuberculosis by mycobacterial culture,with the identification result as mycobacterium tuberculosis complex.The drug sensitivity test was conducted and the test results were analyzed.Results Initial resistance rate of first-line anti-TB drugs:patients with HIV/TB had the highest rate with isoniazid and rifampicin(21.3%,17/80),and patients with non-HIV tuberculosis had the highest rate with streptomycin(11.66%,19/163).The total initial resistance rates of the first-line anti-tuberculosis drugs were 25%(20/80)and 18.40%(30/163).The difference was not statistically significant(P>0.05).The incidence of initial multidrug-resistant tuberculosis was 18.8%(15/80)in the HIV/TB group,and 6.75%(11/163)in the non-HIV tuberculosis group with the difference statistically significant(P<0.05).In the HIV/TB group,there was one patient with 1.3%(1/80)of extensively drug-resistant tuberculosi.There was no statistically significant difference in the total initial resistance rate of second-line antituberculosis drugs(P>0.05).Conclusion Among the initial drug resistance of patients with HIV/TB in Henan,the ratio of isoniazid resistance and rifampicin resistance is the highest,and the incidence of multidrug-resistant tuberculosis is higher than that of patients in the non-HIV tuberculosis group.XDR-TB patients appear among HIV/TB patients.

关 键 词：艾滋病病毒 结核病 初始耐药 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]