摘要
目的了解长春市住院肺结核患者结核分枝杆菌耐药状况,分析住院患者耐药菌谱为进一步指导临床用药方案提供依据。方法选择2012年5月至2013年12月长春市各县区结防机构推送及长春市结核病定点医院确诊的长春地区痰涂片阳性肺结核患者801例,复治487例,初治314例,采用传统罗氏国体培养法和比例法对痰标本进行结核分枝杆菌培养及药物敏感试验。结果 801份痰标本培养阳性菌株747株,结核分枝杆菌中任意耐药菌株426例（57.03%）,其中初治患者和复治患者任意耐药率分别为40.07%（115/287）、75.43%（347/460）,复治患者任意耐药率明显高于初治患者（χ^2=93.67,P〈0.05）。初治患者与复治患者对异烟肼、利福平、氧氟沙星单耐药率相近,差异无统计学意义。耐2种（χ^2=22.89）、耐3种（χ^2=75.98）及耐多药（χ^2=88.37）、广泛耐药（χ^2=9.52）差异有统计学意义（P〈0.05）,25~54岁耐多药及广泛耐药率高于其他年龄段（P〈0.05）。结论涂阳肺结核患者耐药率严重,复治患者为主要耐药人群,重症初治涂阳病人耐药情况不容忽视。
Objective To investigate the drug resistance of Mycobacterium tuberculosis in patients with pulmonary tuberculosis in Changchun, and to provide evidence for further clinical application of drug regimen. Methods 801 cases from the county TB institutions and Changchun City designated TB hospitals diagnosis of Changchun area with sputum smear positive were consecutively recruited in May 2012 to December 2013, which retreatment of 487 cases, the initial treatment of 314 cases. The Changchun City hospital for infectious diseases laboratory culture traditional Roche constitution method and proportion method of included 801 cases of pulmonary tuberculosis patients with sputum specimens for mycobacterial culture and drug sensitive test. Results The 801 sputum samples cultured positive strains 747 isolates and Mycobacterium tuberculosis drug resistant strains of arbitrary 426 cases（57.3%）, at the beginning of the treated patients and retreatment patients with any drug resistance rate were 40.07%（115/287）, 75.43%（347/460） the resistance rate of retreatment patients with any drug was higher than that in the initial treatment patients（ χ^2=93.67,P〈0.005）. There was no significant difference in the single drug resistance rate between the initial treatment and the retreatment. Resistance of two species（χ^2=22.89）, resistant to three（χ^2=75.98） and multi drug resistant（χ^2=88.37）, widely resistant（χ^2=9.52）had significant differences（P〈0.05）. aged 25-54 resistance multidrug and extensively drug-resistant rate were higher than other age and statistical difference（P〈0.05）. Conclusion The resistant rate of smear positive pulmonary tuberculosis patients is serious, and retreatment patients as the main resistance of the people.The drug resistance of the patients of the initial treatment with severe primary smear positive can not be ignored.
出处
《中国公共卫生管理》
2016年第6期884-886,896,共4页
Chinese Journal of Public Health Management
关键词
结核
肺
分枝杆菌
耐药
tuberculosis
pulmonary
mycobacterium
drug resistance
