2016—2020年贵州省利福平耐药肺结核流行特征  

Epidemiological characteristics of rifampicin-resistant pulmonary tuberculosis in Guizhou Province in 2016—2020

作　　者：郭雪丽 陈慧娟[2] 李豫[2] 周建 周姣姣 马晓雪 洪峰[1] 李进岚 GUO Xueli;CHEN Huijuan;LI Yu;ZHOU Jian;ZHOU Jiaojiao;MA Xiaoxue;HONG Feng;LI Jinlan(School of Public Health,Guizhou Medical University,the Key Laboratory of Enviromental Pollution Monitoring and Disease Control,Ministry of Education,Guiyang,Guizhou 550025,China;不详)

机构地区：[1]贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州贵阳550025 [2]贵州省疾病预防控制中心结核病防治研究所

出　　处：《中国预防医学杂志》2023年第6期557-561,共5页Chinese Preventive Medicine

基　　金：贵州省发改委省级基本建设前期工作项目(2020-181-131)。

摘　　要：目的 分析2016—2020年贵州省利福平耐药肺结核(rifampicin-resistant pulmonary tuberculosis,RR-PTB)流行特征,为RR-PTB防控提供理论依据。方法 通过“结核病管理信息系统”收集2016—2020年贵州省登记的RR-PTB患者病案资料进行分析。结果 2016—2020年贵州省共登记RR-PTB病例1 422例,其中单耐利福平肺结核患者数量呈逐年上升趋势(χ^(2)趋势=82.548,P<0.05);患者主要以41~<60岁和21~<41岁男性为主,其中0~<21岁和≥60岁年龄段呈上升趋势(χ^(2)趋势=21.653、9.045,P<0.05);职业以农民和家政家务及待业为主,其中家政家务及待业呈逐年上升趋势(χ^(2)趋势=127.029,P<0.05);主要集中在毕节市、贵阳市和铜仁市,其中铜仁市RR-PTB患者呈上升趋势(χ^(2)趋势=79.074,P<0.05);登记分类以初治失败为主,其中新发和复发患者呈上升趋势(χ^(2)趋势=130.168、9.210,P<0.05);药敏诊断类型以分子核酸检测为主;既往抗结核治疗史以使用过一线药为主,其占比呈上升趋势(χ^(2)趋势=4.719,P<0.05)。结论 贵州省2016—2020年RR-PTB患者数量不断上升,建议在今后防控工作中提高利福平耐药结核病患者医疗费用的报销比例,全面推广快速核酸检测技术,为RR-PTB的早期发现、早期治疗提供有利条件。Objective To understand the epidemiological characteristics of rifampicin-resistant pulmonary tuberculosis(RR-PTB)in Guizhou Province from 2016 to 2020,and to provide a theoretical reference for the prevention and control of RR-PTB.Methods The clinical data of patients with RRPTB in Guizhou Province from 2016 to 2020 were obtained from the TB Management Information System and were analyzed.Results From 2016 to 2020,a total of 1422 cases with RR-PTB were registered in the system,and the prevalence of RR-PTB showed an increasing trend(χ^(2)=82.548,P<0.05).Majority of cases were males in the age group of 41-<60 years and 21-<41 years.However,the number of cases aged 0-<21 years and≥60 years increased(χ^(2)=21.653,9.045,P<0.05).Most patients were farmers,housekeepers and unemployed,and the percentage of housekeepers and unemployed showed an upward trend(χ^(2)=127.029,P<0.05).Patients were mainly from Bijie City,Guiyang and Tongren City,and the percentage of patients in Tongren City increased(χ^(2)=79.074,P<0.05).Most patients registered the system were those who failed with the initial treatment,however,the number of new patients and patients with recurrence TB showed an increasing trend(χ^(2)=130.168,9.210,P<0.05).The molecular nucleic acid testing was the major type of drug susceptibility determination method and most patients were used to be treated with first-line drugs,which also showed an increasing trend(χ^(2)=4.719,P<0.05).Conclusions The number of RR-PTB patients in Guizhou Province increases from 2016 to 2020.It is suggested to increase the reimbursement ratio of total medical costs of patients with RR-PTB,and to comprehensively promote the application of molecular nucleic acid testing technique,so as to provide favorable conditions for the early detection and treatment of rifampin drug-resistant tuberculosis.

关 键 词：肺结核 利福平耐药 耐药性 流行病学 

分 类 号：R521[医药卫生—内科学]