河北省肺结核患者流行病学特征及耐药情况分析  

Analysis of epidemiologic features and drug resistance of pulmonary tuberculosis patients in Hebei Province

作　　者：解冰洁 张俊丽[1] 李梦茹 宋少璇 张会民[1] 徐华[1] 陈海峰[1] XIE Bingjie;ZHANG Junli;LI Mengru;SONG Shaoxuan;ZHANG Huimin;XU Hua;CHEN Haifeng(Tuberculosis Prevention and Control Institute,Hebei Provincial Center for Disease Control and Prevention,Shijiazhuang,Hebei 050021,China)

机构地区：[1]河北省疾病预防控制中心结核病防治所,河北石家庄050021

出　　处：《医学动物防制》2025年第1期51-55,共5页Journal of Medical Pest Control

基　　金：河北省卫生健康委科研基金项目(20220787);河北省卫生厅科技基金项目——河北省结核病耐药性流行病学调查(20190973)。

摘　　要：目的了解河北省2020—2022年肺结核患者的流行病学特征及耐药情况,为制定适合本省的结核病防治策略提供依据。方法2023年1—7月采用描述性流行病学方法对来源于14个监测县(区),2020年1月至2022年12月经分离培养确定为结核分枝杆菌阳性的1144例肺结核患者的数据进行分析。计数资料用百分比表示,率的检验用χ^(2)检验。结果不同性别和年龄组肺结核患者的构成比,差异有统计学意义(χ^(2)=8.509、15.848,P=0.014、0.015),构成比以男性(74.56%)和≥60岁年龄组(40.99%)最高。2020—2022年监测县(区)肺结核患者共分离培养阳性菌株1144株,其中初治1045例,复治99例。初治患者中耐多药的耐药率为2.58%,利福平耐药率为1.15%;复治患者中耐多药的耐药率为6.06%,利福平耐药率为7.07%。耐多药患者中初治患者“异烟肼+利福平、异烟肼+利福平+卡那霉素+氧氟沙星”耐药率最高(0.48%),复治患者“异烟肼+利福平+乙胺丁醇”耐药率最高(2.06%)。结论≥60岁、男性农民结核病患者是耐药结核病的高危人群,临床中应注意规范治疗,减少耐药的发生。注意一线、二线抗结核药物尤其是乙胺丁醇、卡那霉素、氧氟沙星、莫西沙星的规范使用,以降低耐药率。Objective To understand the epidemiologic features and drug resistance of pulmonary tuberculosis patients in Hebei Province,and to provide a basis for the formulation of tuberculosis prevention and control strategy suitable for the province.Methods Descriptive epidemiological methods were used to analyze data on 1144 patients with pulmonary tuberculosis identified to be positive for Mycobacterium tuberculosis by isolation and culture from 14 monitoring counties(districts)from January 2020 to December 2022.Results The constituent ratio of pulmonary tuberculosis patients in different genders and age groups showed statistically significant differences(χ^(2)=8.509,15.848,P=0.014,0.015),and the highest constituent ratio was found in males(74.56%)and≥60 years age group(40.99%).A total of 1144 positive strains were isolated cultured from pulmonary tuberculosis patients in monitored counties(districts)from 2020 to 2022,of which 1045 cases were initially treated and 99 cases were retreated.The multidrug resistance rate was 2.58%and rifampicin resistance rate was 1.15%in initial treatment patients.The multidrug resistance rate was 6.06%and the rifampicin resistance rate was 7.07%in retreatment patients.The multidrug-resistant patients had the highest rate of resistance to"isoniazid+rifampicin,isoniazid+rifampicin+kanamycin+ofloxacin"(0.48%)in initial treatment patients,and"isoniazid+rifampicin+ethambutol"(2.06%)in retreatment patients.Conclusion Male peasants with tuberculosis,aged≥60 years are high risk groups of drug-resistant tuberculosis,and attention should be paid to standardizing treatment in the clinic to reduce the occurrence of drug resistance.Attention should be paid to the standardized use of first-line and second-line anti-tuberculosis drugs,especially ethambutol,kanamycin,ofloxacin,moxifloxacin,to reduce the drug resistance rate.

关 键 词：河北 肺结核 流行病学 耐药 分析 

分 类 号：R521[医药卫生—内科学]