艾滋病合并结核病患者结核分枝杆菌耐药分析  

Analysis of drug resistance of Mycobacterium tuberculosis in AIDS patients with tuberculosis

作　　者：古丽米拉·达列力汗 宋玉霞 李弘 钟燕霞[3] 齐曼古力·吾守尔[1] Dalielihan Gulimila;SONG Yu-xia;LI Hong;ZHONG Yan-xia;Qimanguli Wushouer(Department of Respiratory Medicine,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院呼吸内科,乌鲁木齐830011 [2]新疆医科大学第八附属医院艾滋病临床医学研究中心,乌鲁木齐890013 [3]新疆医科大学第八附属医院呼吸科,乌鲁木齐890013

出　　处：《传染病信息》2022年第3期245-247,258,共4页Infectious Disease Information

基　　金：新疆维吾尔自治区重大科技专项(2017A03006-2)。

摘　　要：目的通过对比分析单纯结核病(tuberculosis,TB)患者与AIDS合并TB(AIDS/TB)患者的结核分枝杆菌(Mycobacterium tuberculosis,MTB)耐药鉴定结果,探讨AIDS/TB患者MTB耐药情况。方法选取2017年1月—2018年12月新疆医科大学第八附属医院收治的268例MTB核酸阳性患者作为研究对象。根据是否合并AIDS分为单纯TB组(n=184)和AIDS/TB组(n=84),对2组患者的MTB耐药结果进行分析。结果2组均以男性患者为主(TB组男性占69.6%、AIDS/TB组男性占70.2%),30~44岁年龄段居多(TB组为59.8%、AIDS/TB组为50.0%),标本类型中以痰液标本构成比较高(TB组为78.8%、AIDS/TB组为72.6%)。2组患者耐药类型构成比排名前4位的均为耐多药、仅二线注射剂耐药、多耐药、利福平耐药,且AIDS/TB组耐多药、仅二线注射剂耐药、多耐药、利福平耐药构成比均高于单纯TB组。AIDS/TB组中耐药TB患者占41.67%(35例),明显高于单纯TB组的27.72%(51例),2组比较差异有统计学意义(P<0.05)。结论AIDS/TB患者的MTB耐药TB发生率明显高于单纯TB患者,对此类患者应进行治疗前耐药检测,并在治疗过程中定期监测耐药情况,以便及时调整方案,提高疗效。Objective The drug resistance of Mycobacterium tuberculosis(MTB)between patients with simple tuberculosis(TB)and patients with AIDS and TB co-infection(AIDS/TB)were compared and analyzed in order to explore the drug resistance situation of MTB in AIDS/TB patients.Methods Two hundred and sixty-eight MTB nucleic acid positive patients admitted to the Eighth Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2018 were selected.According to whether they were complicated with AIDS or not,patients were divided into simple TB group(n=184)and AIDS/TB group(n=84).The drug resistance of MTB in these 2 groups was analyzed.Results Both groups were dominated by male patients(69.6%in TB group and 70.2%in AIDS/TB group),and most of them were 30-44 years old(59.8%in TB group and 50.0%in AIDS/TB group).Sputum specimens accounted for a high proportion in specimen types(78.8%in TB group and 72.6%in AIDS/TB group).In addition,the top 4 drug resistance types in the 2groups were multi-drug resistant,second-line injections resistant,poly-drug resistant,rifampicin resistant,which were higher in AIDS/TB group than TB group,significantly(P<0.05).Moreover,the proportion of drug-resistant TB patients in AIDS/TB group(41.67%,35 cases)was higher than that in the simple TB group(27.72%,51 cases),significantly(P<0.05).Conclusions The proportion of drug resistance of MTB is higher in AIDS/TB group than TB group.It is necessary to pay attention to the drug resistance detection of AIDS/TB patients before treatment,and regularly monitor the drug resistance situation of MTB during treatment,so as to adjust the therapeutic schedule timely and improve the curative efficacy.

关 键 词：艾滋病 结核病 结核分枝杆菌 耐多药结核病 多耐药结核病 DNA微阵列芯片 耐药性检测 

分 类 号：R512.91[医药卫生—内科学]