西藏各地涂阳肺结核患者抗结核药物耐药性分析  

Drug Resistance Analysis of Antituberculosis Drugs for Smear-Positive Pulmonary Tuberculosis Patients in Tibet

作　　者：李景中[1] 王健[1] Li Jingzhong;Wang Jian(Tibet Autonomous Region Disease Control And Prevention Center,Lhasa,Tibet 850000)

机构地区：[1]西藏自治区疾病预防控制中心,西藏拉萨850000

出　　处：《智慧健康》2023年第1期5-9,共5页Smart Healthcare

基　　金：西藏科技计划项目《西藏自治区结核病耐药性基线调查研究》(项目编号:XZ201901-GB-02)。

摘　　要：目的了解西藏自治区下辖6个地级市及1个地区耐药结核病的流行现状和特点,比较各地耐药结核病例分布情况和特点,为制定和完善全区防控措施提供依据。方法以2019年5月1日-2020年4月30日全区结核病防治机构新登记的初治涂阳肺结核患者、复治涂阳肺结核患者和慢性排菌涂阳肺结核患者579例作为调查对象,通过问卷调查、查阅病人相关医疗记录获取患者临床信息,用比例法对异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)、链霉素(SM)、卡那霉素(KAM)、氧氟沙星(OFX)、卷曲霉素(CPM)、丙硫异烟胺(PTO)和氨基水杨酸钠(PAS)9种药物进行敏感性检测;采用描述性研究方法,按照行政区划描述其耐药结核发病情况并作比较。结果共发现耐药谱型39种,包括单耐药9种、多耐药10种、耐多药20种。结论西藏各地抗结核药物耐药谱呈多态性和复杂性,结核病耐药形势严峻,需进一步加强耐药结核病的防治工作。Objective To understand epidemic situation and characteristics of drug-resistant tuberculosis in 6 prefecture level cities and 1 region in Tibet Autonomous Region,and compare distribution and characteristics of drug-resistant tuberculosis cases in different regions,and provide basis for formulating and improving regional prevention and control measures.Methods The paper chose 579 new smear positive pulmonary tuberculosis patients,retreated smear positive pulmonary tuberculosis patients and chronic smear positive pulmonary tuberculosis patients registered in tuberculosis prevention and control institutions in the whole region from May 1,2019 to April 30,2020 for investigation,to achieve clinical information of patients through questionnaire survey and consulting relevant medical records of patients.Isoniazid(INH),rifampicin(RFP),ethambutol(EMB),streptomycin(SM),kanamycin(KAM)sensitivity of 9 drugs was tested by proportion method,including ofloxacin(OFX),capreomycin(CPM),propylthioisoniazide(PTO)and sodium aminosalicylate(PAS).Incidence of drug-resistant tuberculosis was compared with descriptive research method according to administrative divisions.Results A total of 39 drug resistance patterns were found,including 9 single drug resistance,10 multi drug resistance and 20 multi drug resistance.Conclusion Drug resistance spectrum of tuberculosis drugs in Tibet is polymorphic and complex,with severe drug resistance form of tuberculosis.It is necessary to strengthen prevention and treatment of drug resistant tuberculosis further.

关 键 词：肺结核 抗结核药物 耐药性 

分 类 号：R521[医药卫生—内科学]