辽宁省耐多药结核病可疑者筛查及病人发现情况分析

Screening of suspicious patients with multidrug-resistant tuberculosis and analysis of patients discovery in Liaoning Province

目的通过分析辽宁省耐多药结核病(multidrug-resistance tuberculosis,MDR-TB)可疑者筛查情况以及病人的发现情况,为加强耐多药病人发现、制定耐多药防治策略提供科学依据。方法收集2015-2017年在"结核病信息管理系统"登记的进行MDR-TB可疑者筛查的相关数据资料,应用χ2检验的方法对数据进行分析。结果2015-2017年新涂阳病人耐多药筛查率分别为26.2%、45.1%、59.9%,3年间新涂阳病人耐多药筛查率差异有统计学意义(χ2=871.47,P<0.05);2015-2017年高危人群耐多药筛查率分别为29.5%、61.8%、66.1%,差异有统计学意义(χ2=548.81,P<0.05);2015年新涂阳病人和高危人群耐多药病人检出率分别为9.5%、27.6%,差异有统计学意义(χ2=92.05,P<0.05);2016年新涂阳病人和高危人群耐多药病人检出率分别为9.7%、29.1%,差异有统计学意义(χ2=183.60,P<0.05);2017年新涂阳病人和高危人群耐多药病人检出率分别为9.1%、33.3%,差异有统计学意义(χ2=396.32,P<0.05);其中复治失败的MDR-TB病人检出率最高,为36.4%,各登记分类病人检出率差异有统计学意义(χ2=52.99,P<0.05);2015-2017年MDR-TB病人的检出率分别为14.2%、16.1%、17.3%,差异有统计学意义(χ2=8.94,P<0.05)。结论新涂阳病人及高危人群两类可疑者耐多药筛查率均逐年上升,但高危人群筛查率与国家"十三五规划"指标要求的95%以上仍有差距;高危人群的耐多药病人检出率明显高于新涂阳病人,各登记分类病人中复治失败MDR-TB病人检出率最高。

Objective To provide a scientific basis for strengthening the detection of patients with multidrug-resistant tuberculosis(MDR-TB)and formulating MDR-TB control strategies by analyzing the screening of suspicious patients with multidrug-resistant tuberculosis and patients discovery in Liaoning Province.Methods Data related to the screening of suspicious MDR-TB patients registered in the Tuberculosis Information Management System from 2015 to 2017 were collected,and the data were analyzed byχ2 test.Results From 2015 to 2017,the MDR-TD screening rate of active cases were respectively 26.2%,45.1%,59.9%,with statistically significant difference in the three years(χ2=871.47,P<0.05).From 2015 to 2017,the MDR screening rates in high-risk groups were respectively 29.5%,61.8%and 66.1%,with a statistically significant difference in the three years(χ2=548.81,P<0.05).In 2015,the detection rates of MDR in new smear positive cases and high-risk groups were respectively 9.5%and27.6%,with a statistically significant difference(χ2=92.05,P<0.05).In 2016,the detection rates of MDR in new smear positive cases and high-risk groups were respectively 9.7%and 29.1%,with a statistically significant difference(χ2=183.60,P<0.05).In 2017,the detection rates of MDR in new smear positive cases and high-risk groups were respectively 9.1%and33.3%,with a statistically significant difference(χ2=396.32,P<0.05).The detection rate of MDR-TB patients who failed in retreatment was the highest(36.4%).There was a statistically significant difference in the detection rate of patients in each registration categories(χ2=52.99,P<0.05).The detection rates of MDR-TB patients from 2015 to 2017 were 14.2%,16.1%and 17.3%,respectively,with statistically significant differences(χ2=8.94,P<0.05).Conclusion The screening rate of MDR in new smear positive cases and high-risk groups is increasing year by year,but there is still a gap between the screening rate of high-risk population and the national 13 th Five-Year Plan targets which are requaired more than 95%.The detection rate of MDR-TB patients in high-risk groups is significantly higher than that of new smear positive cases,and the detection rate of MDR-TB patients with the highest recurrence of re-treatment in each of the registered patients is the highest.