乌鲁木齐市259例肺结核患者药敏结果分析

Analysis on drug sensitive test of 259 cases of tuberculosis in Urumqi

目的调查乌鲁木齐市肺结核患者对8种抗结核药物的耐药情况。方法将2011年5月1日-2012年9月30日间,乌鲁木齐市7区1县疾控中心结核病防治科收治的肺结核患者标本,用改良罗氏管进行分枝杆菌分离培养,培阳性菌株采用比例法对8种抗结核药物(异烟肼、利福平、乙胺丁醇、链霉素、氧氟沙星、卡那霉素、阿米卡星、卷曲霉素)进行药物敏感性试验,并对其耐药情况进行统计分析。结果 259例肺结核患者做药敏试验,其中耐药肺结核患者71例,总耐药率为27.41%,耐多药率为7.72%,广泛耐药率为3.09%。一线抗结核药物的耐药顺序为:异烟肼>链霉素>利福平>乙胺丁醇。原发性耐药与获得性耐药相比,耐多药患者经统计学分析差异有统计学意义(χ2=8.57,P=0.03)。结论对初治肺结核患者要实施有效的治疗管理,确保患者能规律治疗;对复治病人尽可能做药敏试验,依据药敏结果做个体化治疗。

Objective To investigate the drug resistance status of tuberculosis patients to 8 kinds of anti-tuberculosis drugs.Methods The specimens collected from tuberculosis patients received and cured in CDC of seven areas and one county in Urumqi were cultured with improved L-J medium.Culture positive strains were conducted with drug sensitive test on 8 anti-tuberculosis drugs by ratio method： INH,RFP,EMB,SM,OFX,KM,AMK and CPM.Then the drug resistance of them was statistically analyzed.Results A total of 259 patients were tested on drug sensitivity,including 71 drug resistant tuberculosis patients.Total drug resistance rate was 27.4%,multiple drug resistance rate was 7.72%,and extensively drug resistance rate was 3.09%.The order of drug resistance was： INH SM RFP EMB.Compared with primary drug resistance,there were significant statistical differences among multi-drug resistant patients（χ2= 8.57,P = 0.03）.Conclusions Effective treatment should be implemented on patients with initial tuberculosis treatment,so as to ensure regular treatment on patients;Drug sensitive test should be carried out on patients as much as possible,and individualized treatment need to be made based on drug sensitive test results.