邯郸市耐药肺结核患者耐药状况分析

Analysis on tuberculosis patients drug resistance situation in Handan City

目的研究耐药结核病患者的耐药状况,为耐药结核病防控提供科学有效的依据。方法收集2010年1月1日~2014年6月30日期间邯郸市17个监测门诊2 113例涂阳肺结核患者痰标本,对分离培养获得的1 631株阳性标本用分枝杆菌药物敏感性测定法（比例法）进行异烟肼、利福平、卡那霉素、氧氟沙星耐药性测定。结果 1 631株阳性菌株中初治患者1 246例（76.39%）、复治患者385例（23.61%）。发现耐多药患者256例,广泛耐药患者28例。耐多药和广泛耐药患者中男性199例、女性85例,男女比2.34∶1;年龄最小16岁,最大85岁,平均45.3岁。总耐药率33.17%,其中初治22.71%、复治65.97%,复治总耐药率明显高于初治总耐药率,差异有统计学意义（χ^2=249.253,P〈0.05）。初复治患者耐多药率15.70%,其中初治7.87%、复治41.04%,复治耐多药率是初治的5.2倍,差异有统计学意义（χ^2=244.613,P〈0.05）。初复治广泛耐药率1.72%,其中初治1.04%、复治3.90%,复治广泛耐药率是初治的3.75倍,差异有统计学意义（χ^2=14.186,P〈0.05）。结论邯郸市耐药结核病疫情异常严峻,防控工作重点是以复治涂阳肺结核患者为重点的高危人群。

Objective To study the drug resistance status of drug - resistant tuberculosis person, provide scientific and effective basis for drug - resistant TB prevention and control. Methods Collecting 2113 cases of smear positive tuberculosis patients from all 17 monitoring outpatient specimens in handan during the period from 2010. 1.1 to 2014. 6. 30, 1 631 samples of positive specimens cultivated from all were dealt with isoniazid, rifampicin, kanamyein, ofloxacin resistance measurement by myeobaeterial drug sensitivity assay （ ratio method） . Results There were 1 246 cases （76. 39% ） in the early cure, 385 cases （23.61%） of recurrent patients in all 1 631 strains of positive strains. There were 256 cases of multi -drug resistant patients, and 28 cases of extensively drug - resistant patients. In all Multidrug - resistant and extensively drug - resistant patients, 199 cases of the men and women in 85 cases, male and female patients than 2. 34： 1, the youngest 16 years old, biggest 85 years old, the average age of 45.3 years, the total resistance was 33.17% in Early recurrent patients, in which, the resistance rates of the initialpatients was 22. 71% and the rate of recurrent patients was 65.97%. There was statistical differences （χ^2 =249. 253, P 〈0. 05）. The total rate of multi - drug resistant was 15.70%, in which, the multi - drugresistance rates of the initial patients was7.87% , and the rate of recurrent patients was41.04%. There was statistical differences （χ^2 = 244. 613, P 〈 0. 05） . The total widely drug - resistancerate was 1. 72% , in which, thewidely drug - resistance rates of the initial patients was1. 04% , and the rate of recurrent patients was 3.90%. There was statistical differences （χ^2 = 14. 186, P 〈 0. 05 ） . Conclusion Handan drug - resistant TB epidemic is extremely severe. Focus on the prevention and control work is retreatment smear positive pulmonary tuberculosis patients.