2013年新疆436例不同民族住院结核病患者的耐药情况分析

Analysis of drug-resistance of hospitalized tuberculosis patients in 436 different nationalities of Xinjiang in 2013

目的了解住院结核病患者的耐药情况,为制定合理的治疗方案提供依据。方法分析2013年1月~12月新疆维吾尔自治区胸科医院住院耐药结核病患者的耐药情况。结果 436例耐药结核病患者中对抗结核药物耐药率前4位从高到低依次异烟肼（65.5%）、链霉素（56.4%）、利福平（53.9%）、利福布丁（40.6%）;复治结核病患者对利福平、异烟肼、利福布丁、氧氟沙星、左氧氟沙星、环丙沙星的耐药率高于初治患者高;初治患者中单耐药构成比最大,为49.5%,复治患者中耐多药构成最大,占50.4%;不同民族结核病患者对利福布丁、吡嗪酰胺、利福喷丁、阿米卡星单种抗结核药物耐药率差异均有统计学意义（均有P〈0.05）,利福布丁在哈萨克族中耐药率最高,有33例,占60.0%;学生、干部患者单耐药较多,分别占50.0%,47.6%,待业及自由职业者中耐多药比例较高,占52.1%。既往结核治疗中有间断患者中耐多药比例比无间断患者大,分别占55.4%,44.6%。结论本次住院结核病患者结核分枝杆菌耐药以耐异烟肼、利福平最常见,复治患者耐多药率较高。

Objective To uncover the situation of drug resistance in tuberculosis（TB） of hospitalized patients and provide a basis for appropriate treatment.Methods Analysis on the status of drug-resistance tuberculosis（DR-TB） of inpatient was performed in the Xinjiang Autonomous Region Chest Hospital between January and December in 2013.Results436 cases of patients with DR-TB had anti-TB drug resistance,including isoniazid（65.5%）,rifampicin（56.4%）,streptomycin（53.9%）,and rifabutin（40.6%）.Among retreatment TB patients rifampin,isoniazid,rifabutin,ofloxacin,levofloxacin,and ciprofloxacin drug resistance rates were relatively higher than the primary TB patients（PDR-TB,P〈0.05）.The constituent ratio of DR-TB was the highest in PDR-TB（49.5%）; the constituent ratio of multidrug-resistant patients（MDR-TB） is the highest in retreatment TB patients（50.4%）.Different ethnic groups had significant differences in the rate of single anti-tuberculosis drug resistance to pyrazinamide,rifabutin,rifapentine and Amikacin（all P〈0.05）.Rifabutin was in the highest resistant rate in Kazak,accounting for 60.0%.DR-TB patients was more in students and officers,accounting for 50.0% and 47.6%.PDR-TB patients were more in unemplyed freelancers,accounting for 52.1%.The proportion of MDR of previous treatment of tuberculosis patients with interrupted treatments were high（55.4%） compared with the tuberculosis patients with continens treatments（44.6%）.Conclusions Drug-resistant mycobacterium tuberculosis showed most commonly resistance to isoniazid,rifampin,streptomycin.