摘要
目的对开封市耐药结核病流行状况进行基线调查,了解本地结核病疫情以及控制现状,为制定本市耐多药结核病的防控策略提供参考依据。方法对201 1年3月至2012年8月间开封市全部县区结防机构登记报告的1 033例涂阳肺结核患者的痰标本,由市级结防机构统一进行痰培养,培养阳性者进行抗结核药物的敏感性试验。对910例有检测结果的结核分枝杆菌耐药情况进行分析,其中男性707例,女203例,性别比为3.48:1;年龄14~91岁,平均(49.48±16.09)岁;初治涂阳748例(占82.20%),复治涂阳162例(占17.80%);对检测结果使用SPSS16.0进行统计分析。结果开封市涂阳肺结核患者总耐药率为24.84%(226/910)低于2007-2008年全国结核病耐药性基线调查耐药率39.12%(1 537/3 929)(x^2=65.10,P<0.05);涂阳患者中总耐多药率6.15%(56/910)和初治患者耐多药率2.27%(17/148)低于全国耐药基线调查的耐多药率8.32%(x^2=14.23,P<0.05)和5.71%(x^2=8.21,P<0.05;);而复治涂阳患者耐多药率24.07%(39/162)与全国耐多药率25.64%相比差异无统计学意义(x^2=0.12,P>0.05)。结论近年开封市耐药结核分枝杆菌流行的总体情况低于全国平均水平,结核分枝杆菌耐药以复治患者为主,因此耐药结核病控制工作应注重早期发现、加强初治肺结核患者的有效治疗与管理,避免耐药结核分枝杆菌的发生,有效控制耐药结核病传播。
Objective To analyze the present epidemic status of MDR-TB of Kaifeng Prefecture in Henan, to provide valuable evidence for making the current control policy of drug-resistant MTB. Methods From March 2011 to August 2012, the sputum samples of all 1 033 new registered sputum smear-positive TB patients in county-level TB dispensaries were collected and delivered to the Prefecture for Mycobacterium culture and DST. Finally 910 cases with test resuhs were included in the analysis. Of total, 707 cases were male and 203 cases were female and the sex ratio was3.48：1. The age range of the patients were 14 to 91 years old and the average age was （49 ＋ 20） years old. Of total, 748 cases （82.20 % ） were new patients and 162 cases （ 17.80 % ） were retreatment patients. The SPSS 16.0 was used for statistical analy- sis. Results The total drug resistance （TDR） rate was 24.84 %（226/910） , lower than the findings of 39.12 % （ 1 537/3 929）（x2=65.10,P〈 0.05 ）of National Survey of Drug-Resistant Tuberculosis in China in 2007-2008. The mnl- tidrug resistance （MDR）rates of new smear positive patients and retreatment patients were 2.27 %（ 17/148 ）and 24.07 % （39/162）, the differences were significant （x2=109.60,P 〈 0.01）. But the retreatment patients rate 24.07 % （39/162） contrast with the findings of National Survey of Drug-Resistant Tuberculosis in China was all no significant difference （x2=0.12, P 〉 0.05）.Conclusions Epidemic status of MDR-TB of Kaifeng Prefecture lower than the national average. The major Drug resistances of Mycobacterium tuberculosis patients are retreatment patients. Therefore the future control work should focus on early detection, and effective treatment and management to the new patients, In order to controlthe spread of drug-resistant MTB.
出处
《河南预防医学杂志》
2014年第2期100-103,117,共5页
Henan Journal of Preventive Medicine
基金
中国卫生部-比尔.梅琳达和盖茨基金会结核病防治项目(2009-04-01)
关键词
结核病
预防与控制
结核分枝杆菌
耐药
Pulmonary/prevention and control, Mycobacterium tuberculosis, Drug resistant
