2013-2022年烟台市结核病患者抗结核药物耐药监测结果分析  

Analysis on drug resistance monitoring results of tuberculosis patients in Yantai city from 2013 to 2022

作　　者：王淑蕾[1] 甄丽丽 吴峰 任晓华 刘靖宇[1] 王曰雷[1] WANG Shu-lei;ZHEN Li-li;WU Feng;REN Xiao-hua;LIU Jing-yu;WANG Yue-lei(Department of Tuberculosis Control,Yantai City Center for Disease Control and Prevention,Shandong 264003,China;Clinical Lab,Yantai Beihai Hospital)

机构地区：[1]烟台市疾病预防控制中心结核病防制科,山东264003 [2]烟台市北海医院检验科

出　　处：《预防医学论坛》2024年第6期406-410,共5页Preventive Medicine Tribune

基　　金：山东省医药卫生科技发展计划项目(202112050277)。

摘　　要：目的探讨2013-2022年山东省烟台市结核病患者对三类一线抗结核药物的耐药监测结果,分析烟台市耐药结核病的流行特征,为制定耐药结核病防控措施提供科学依据。方法选取2013-2022年烟台市完成异烟肼、利福平、乙胺丁醇三类一线抗结核药敏试验的结核病患者2543例作为研究对象,计算耐药率,通过χ^(2)检验或Fisher确切概率检验对各类人群之间的耐药率进行比较,分析药敏监测结果。结果烟台市10年间结核病患者三种药物任意耐药率为11.56%(294/2543),其中单耐药率、耐多药率和多耐药率分别为6.06%(154/2543)、5.15%(131/2543)和0.35%(9/2543),以耐利福平和异烟肼为主。耐药患者中初治患者占全部患者的72.11%(212/294),复治患者占27.89%(82/294)。初治患者任意耐药率为9.73%(212/2178),复治患者任意耐药率为22.47%(82/365),初治患者任意耐药率低于复治患者,差异有统计学意义(χ^(2)=107.84,P<0.01)。所有耐药患者中≥60岁患者占比51.02%(150/294),农民占比71.77%(211/283)。近10年来烟台市结核病耐药率呈波动下降趋势。结论烟台市结核病患者的抗结核药物耐药率呈下降趋势,耐药患者以初治患者为主,老年男性患者及农村人口是耐药结核病防治应关注的重点人群。Objective To explore the monitoring results of drug resistance of tuberculosis patients to 3 types of first-line anti-tuberculosis drugs in Yantai city from 2013 to 2022,analyze the epidemic characteristics of drug-resistant tuberculosis,so as to provide scientific basis for the prevention and control of drug-resistant tuberculosis.Methods A total of 2543 tuberculosis patients who completed the first-line anti-tuberculosis drug susceptibility test in Yantai city from 2013 to 2022 were selected as the study objects,the drug resistance rate was calculated,and the drug resistance rate among various populations was compared byχ^(2)test or Fisher exact probability test,and the drug susceptibility monitoring results were analyzed.Results The random drug resistance rate of TB patients in Yantai city during 10 years was 11.56%,among which the single drug resistance rate,multidrug resistance rate and poly resistance rate were 6.06%,5.15%and 0.35%,respectively,and the main drug resistance was nilfampicin and isoniazid;among the drug-resistant patients,the initial treatment patients accounted for 72.11%(212/294),and the retreated patients accounted for 27.89%(82/294).The random drug resistance rate of the initial treatment patients was 9.73%(212/2178),and that of retreated patients was 22.47%(82/365).The random drug resistance rate of initial treatment patients was lower than that of retreatment pa-tients,and the difference was statistically significant(χ^(2)=107.84,P<0.01);Among all drug-resistant patients,patients≥60 years old accounted for 51.02%(150/294)and farmers accounted for 71.77%(211/283);in recent 10 years,the resistance rate of tuberculosis in Yantai city showed a trend of decline with fluctuation.Conclusion The drug resistance rate of tuberculosis patients in Yantai city showed a downward trend.The drug-resistant patients are mainly newly treated patients.The elderly male patients and the rural population are the key groups that should be paid attention to in the prevention and control of drug-resistant TB.

关 键 词：结核 肺 监测 初治 复治 耐药 

分 类 号：R521[医药卫生—内科学] R978.3[医药卫生—临床医学]