我国结核病耐药状况及其变化趋势分析

Analysis of the Status and Trend of Drug Resistance of Tuberculosis in Chinese Population

目的:了解结核病总体耐药、初始耐药和获得性耐药状况及其变化趋势,为改进结核病防治措施提供参考。方法:对国内1995～2005年结核病耐药监测结果进行综合评价,应用SPSS软件进行统计学分析。结果:1995～2005年我国人群结核耐药趋势总体呈下降趋势,总耐药率为24．8％。在耐药病例中,初始耐药率为20．6％,获得性耐药率为44．3％,获得性耐药率显著高于初始耐药率。不同抗结核药物的耐药顺序为:初始耐药异烟肼(15．3％)>链霉素(10．6％)>利福平(8．1％)>乙胺丁醇(4．2％);获得性耐药异烟肼(35．1％)>利福平(26．1％)>链霉素(23．3％)>乙胺丁醇(11．3％)。耐多药率中,1～4种耐药率按年份均呈缓慢下降趋势。耐药率排序为:单药>2药>3药>4药,耐多药率显著高于耐单药率。结论:我国人群结核耐药趋势总体呈缓慢下降趋势,但与发达国家相比,仍属高耐药水平,面临的形势依然十分严峻。

OBJECTIVE： To understand the status and trend of drug resistance of mycobacterium tuberculosis（TB） in China, and provide evidence for TB control strategies with the studies on supervision of TB drug sensitivity, test in Chinese population .METHODS： The comprehensive evaluation study on the results to drug resistance in Tuberculosis during 1995- 2005 in china.Carries on the computation using the SPSS software.RESULTS： The total drug resistance rate in Chinese population showed a decreasing trend from 1995 to 2005.In the resistant cases,the total frequency of drug resistance was 24.8%, initial drug resistance（IDR）20.6% ,acquired drug resistance（ADR） 44.3%. Comparing with the IDR rate, the ADR rate had a significant high level.Four anti tuberculosis drugs resistant rate order. IDR is Isoniazid（15.3%） 〉 Streptomycin（10.6%） Rifampicin（8.1% ） 〉 Ethambutol（4.2% ）, ADR is Isoniazid（35.1% ） 〉 Rifampicin（26.1% ） 〉 Streptomycin（23.3% ） 〉 Ethambutol（l1.3%） . In one to four drug resistant rate showed a slow decreasing trend. The drug resistant rate order was. one drug resistant rate〉 two drug resistant rate〉 three drug resistant rate〉 four drug resistant rate.Comparing with the one drug resistant rate,the multi - drug resistant rate had a significant difference.CONCLUSION：The total drug resistance rate in Chinese population showed a decreasing trend.Comparing with the developed country,the drug resistance rate in China is high level.The situation is still quite serious.We must take initiative in TB control to prevent the prevalence and spread of drug resistance tuberculosis, especially of multidrugs resistance tuberculosis.