摘要
目的及时掌握我国各个省份的结核病药物耐药性水平,并且作到国际可比。方法采用 WHO 推荐的《结核病药物耐药性监测指南》规定的统一方法进行监测设计和操作。根据各省前一年的涂片阳性的病例数,计算出应监测的病例数,采用随机抽样的方法,在各省选择30个监测点(广东为40个监测点),将监测病例平均分配到各个监测点。每个监测点连续选取涂片阳性的病例,收集痰标本,进行分枝杆菌培养及利福平(RFP 或 R)、异烟肼(INH 或 H)、链霉素(SM 或 S)和乙胺丁醇(EMB 或 E)4种药物的药物敏感性实验。结果河南、山东、浙江、广东、湖北、辽宁、河南省第二轮监测以及内蒙古自治区的初始耐药率分别是:35.0%(226/646)、17.6%(178/1009)、14.8%(120/809)、18.6%(267/1432)、17.5%(150/859)、42.1%(344/818)、29.8%(364/1222)和35.7%(313/876);获得性耐药率分别为:66.O%(479/726)、50.O%(110/220)、59.3%(86/145)、33.7%(56/166)、44.5%(106/238)、55.8%(48/86)、60.8%(161/265)和65.3%(252/386)。结论从开展耐药性监测的各省耐药监测结果看,我国的耐药状况仍处于很高的水平。应当引起我们的高度重视,采取有力措施,加强结核病控制工作,控制耐药结核病,减少耐药菌株的蔓延。
Objective To explore the drug resistance level in different provinces in China and to obtain DRS result comparable with other countries. Methods WHO guideline on DRS was adopted to design and perform. According to the notified smear positive cases in the previous year, sample size for smear positive cases was estimated. 30 sites for each province were selected following the randomly sampling principle （40 sites in Guangdong province）. Each site included same number of cases continuously. Sputum was collected for culture and stains were collected to perform DST for RFP,IHN,SM and EMB. Results Primary drug resistance in Henan, Shandong, Zhejiang, Guangdong, Hubei, Liaoning and Henan（2nd round） were 35.0% （226/646）, 17.6% （178/1009）, 14.8% （120/809）, 18. 6% （267/1432）, 17.5% （ 150/859 ）, 42. 1% （344/818）, 29.8% （364/1222） and 35.7% （313/876）, respectively. Required resistance were 66. 0% （479/726） ,50. 0% （ 110/220 ）, 59. 3% （ 86/145 ）, 33.7% （ 56/166 ）, 44. 5 % （ 106/238 ）, 55. 8% （48/86） ,60. 8% （ 161/265 ） and 65. 3% （ 252/386 ）, respectively. Conclusions The result of DRS in different province shows that the drug resistance level in China is quite high. We should pay great attention to this and adopt effective measure to strengthen TB control to reduce the prevalence of drug resistance.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2007年第8期863-866,共4页
Chinese Journal of Laboratory Medicine
关键词
结核
药物耐受性
药物监测
Tuberculosis
Drug resistance
Drug monitoring
