我国耐多药结核病高负担地区耐多药结核病人的性别和年龄分布特征

Gender and age distributions of MDR-TB in high MDR-TB burden areas of China

目的了解我国耐多药结核病高负担地区耐多药结核病人的性别和年龄分布特征，为制定结核病控制政策提供科学依据。方法按WHO／IUATLD《结核病耐药监测指南》进行耐药监测，选择4个耐多药结核病（MDR—TB）较高的省，其监测结果运用SPSS13．0软件进行分析。结果总耐多药率为13．4％，初始耐多药率和获得性耐多药率分别为8．2％和34．4％，获得性耐药率明显高于初始耐多药率（P〈0．01）。从不同性别的耐多药率来看，男性与女性的获得性耐多药率分别为32．5％和39．3％，女性获得性耐药率显著高于男性（P〈0．05）。不同年龄组的耐多药率中，各年龄组的初始耐多药率范围为6．4％～9．1％，60以上年龄组偏低，而各年龄组的获得性耐多药率范围为30．4％～40．3％，20～40岁年龄组的获得性耐多药率明显高与其他年龄组（P〈0．05）。结论在结核病的治疗管理方面，应关注女性患者和20～40岁年龄组的患者，重点预防该特征人群获得性耐多药的产生，减少耐多药结核菌在人群的传播。

Objective To understand the gender and age distributions of MDR- TB in high MDR- TB burden areas of China, and provide evidence for making TB control policy. Methods Based on the ＂Guidelines for surveillance of drug resistance in tuberculosis＂ developed by WHO]IUATLD, the surveillance of TB drug resistance has been conducted in China. The data from four provinces with high MDR - TB burden were analyzed with SPSS 13.0. Results The total MDR- TB rate was 13.4%, among them initial MDR- TB rate was 8.2%and acquired MDR- TB rate was 34.4%. The acquired MDR- TB rate was significantly higher than initial MDR - TB rate （P〈0.01）. The acquired MDR- TB rate in female （39.3%） was higher than that in male （32.5%） （P〈0.05）. The range of initial MDR- TB rate in different age group was 6.4 % --9.1% and the age group of over 60 was comparable lower. The range of acquired MDR - TB rate in different age group was 30.4 % -- 40.3 % and 20-- 40 age group was significantly higher than other age groups （P 〈 0.05 ）. Conclusion In addition to taking comprehensive measures to prevent the emergence of MDR - TB, the treatment and management for female TB patient and 20--40 age group TB patients should be paid more attention in order to further prevent acquired MDR - TB and reduce MDR - TB transmission in the community.