深圳市耐多药结核病人管治效果初步评价

Evaluation on management and treatment of MDR-TB patients in Shenzhen

目的分析深圳市耐多药肺结核的诊断、治疗、管理及其效果,并为制定耐多药肺结核病防治对策提供参考依据。方法政府提供专项经费;确保结核分枝杆菌实验室的质量保障;确保一、二线抗结核药物的供应;DOT管理的患者接受免费的一、二线抗结核药物、治疗监测和DOT管理服务;全程管理服务的患者接受免费的治疗监测。结果2003—2006年,共有111例接受治疗,出现不良反应率60.4%,治疗成功率59.5%,丢失率18.9%,失败率11.7%;48例耐多药肺结核病人接受DOT免费管理,治愈34例,治愈率70.8%。63例耐多药肺结核病人接受自费的全程管理,治愈22例,治愈率34.9%。结论逐步推行DOTS-plus策略,可提高耐多药肺结核的治愈率,减少耐药结核的传播。

Objective To evaluate the diagnosis, treatment and management of MDR-TB cases in Shenzhen city and to provide scientific evidence for MDR-TB control and prevention. Meth- ods Government provided special fund. The quality of the TB laboratory was guaranteed. The supply of the first-line and second-line anti-tuberculosis drugs was ensured. Patients treated under DOT were supplied with free first-line and second-line anti-tuberculosis drugs, treatment surveil- lance and DOT management. Patients treated under whole course management were provided free treatment surveillance. Results One handred and eleven＇MDR-TB cases were treated from 2003 to 2006. Side-effect rate was 60.4%, treatment success rate was 59.5%, default rate was 18. 9% and failure rate was 11.7%. 48 of all were treated under DOT, 33of whom were cured. The cured rate was 70. 8%. Sixty-three of all were treated under whole course management, 22 of whom were cured. The cured rate was only 34.9%. Conclusions DOTS-plus strategy should be implemented increasingly in all population, so that to control the spread of DR-TB.