四川泸州地区耐多药及广泛耐药结核病的临床特点

The clinical characteristics of multidrug resistant and extensively drug-resistant tuberculosis in Luzhou

目的分析泸州地区耐多药结核(MDR-TB)及广泛耐药结核病(XDR-TB)的临床特点,为早期发现及防治提供临床经验。方法采集泸州地区2013年1月至2016年10月1 218例痰涂片阳性肺结核患者临床资料,并对痰标本进行传统罗氏培养,培养菌株再进行线性探针杂交试验。对杂交试验提示为MDR-TB的菌株进行传统药物敏感试验,探讨传统药敏试验MDR-TB及XDR-TB的结核患者,并对其进行电话问卷调查,分析临床特点。结果涂片阳性标本总计1 218例,最终获得结核分枝杆菌1 055例,非结核分枝杆菌41例。结核分枝杆菌耐药标本188例,总耐药率17.82%(188/1 055),耐多药率9.67%(102/1 055)。MDR-TB患者102例,主要为男性(77.45%)、中老年(79.41%)、农民(80.39%)及复治(75.49%)患者。结论泸州地区MDR-TB情况严重。MDR-TB患者的依从性普遍较差;应特别重视复治及农民工的MDR-TB及XDR-TB问题。

Objective To analyze the clinical features of multi-drug resistant tuberculosis （MDR-TB） and extensively drug-resistant tuberculosis （XDR-TB） in Luzhou region and provide clinical experience for its early detection and prevention. Methods A total of 1 218 sputum smear-positive pulmonary tuberculosis patients were collected from January 2013 to October 2016.All the sputum specimens were cultured by Lwenstein-Jensen culture.The tresistance to RFP and INH was rapid detected by the line probe assays.The epidemiological characteristics of MDR-TB patients in Luzhou region were analyzed. Results A total of the samples were 1 218 from January 2013 to October 2016,including 1 055 Mycobacterium tuberculosis strains,41 cases of Nontuberculous Mycobacteria （NTM）.A total of 188 samples were drug-resistancet,17.82% （188/1 055） and 9.67 % （102/1 055） showed drug-resistance and multi-drug resistance,respectively.The main prevalent clinical features were male （77.45%）,middle-aged and elderly （79.41%）,peasant（80.39%） and retreatment （ 75.49 %） in 102 MDR-TB patients. Conclusion The prevalence of MDR-TB/XDR-TB is serious in Luzhou region.Compliance with MDR-TB patients is generally poor;the retreatment and migrant workers should be special attention.