云南省耐多药结核病患者特征分析

Analysis on characteristics of multi-drug resistance tuberculosis patients in Yunnan province

[目的]分析云南省耐多药结核病（MDR-TB）患者的分布特征,以期为MDR-TB防治提供参考。[方法]收集2012年1月1日-2015年6月30日云南省耐多药结核病患者筛查信息,进行回顾性分析。[结果]进行传统药敏试验并报告结果的可疑者4491例,确诊270例,MDR-TB检出率6.01%。其中男性205例（75.93%）,女性65例（24.07%）。检出率以0~14岁组最高,其次为45~54岁组,差异有统计学意义。检出率非农民组高于农民组,且差异有统计学意义。患者中现住址在经济较好地区者例数多于经济中等地区,且差异有统计学意义。在检出的270例患者中,有用药相关情况共计195例,其中新患者中有使用二线药物的情况。纳入MDR-TB患者延迟情况分析患者253例,其确诊延迟中位数为220 d,四分位数为（125 d,422.5d）,延迟最短为7 d,最长为7625 d,不同性别、年龄、职业、地区、登记分类其延迟情况差异无统计学意义。[结论]现行MDR-TB筛查策略可行应全面推广,同时应扩大卫生服务可及性缩短患者确诊时间,重点关注非农民及35~54岁患者,减少耐多药结核病的产生。

Objective To analyze the distribution characteristics of MDR-TB patients in Yunnan province so as to provide reference for MDR-TB prevention. Methods Collected the data of MDR-TB patients from Jan. 1,2012 to Jun. 30,2015,screened and retrospective analyzed the information. Results Traditional drug susceptibility tested（ DST） and reported 4491 cases MDR-TB suspects and 270 were confirmed. MDR-TB relevance ratio was 6. 01%. 205（ 7593%） cases were males,65（ 24. 07%） cases were females. The highest detection rate was from 0to 14 years old age group,followed was from 45 to 54 years old age group. There was statistically significant（ P 0. 05） in difference. The detection rate of non farmers was higher than the farmers. There was statistically significant（ P 0. 05） in difference. Among 270 patients,there were 195 cases had drug-related situation,new patients used the second-line drugs. 253 cases of MDR-TB patients were brought into the delay analysis,the diagnosis delay median was 220 d,quartile was（ 125 d,422. 5d）. The shortest delay was 7d,the longest was 7625 d.There was no statistically significant in different gender,age,occupation,region and registration categories of its delay. Conclusions Current MDR-TB screening measure is feasible,we should promote comprehensively. Meanwhile,we should expand the availability of health services to shorten the diagnosed time of patient,focusing on non-farmers and 35 to 54 years-old patients,reducing the production of MDR-TB.