汕头市耐多药结核病患者治疗情况分析

Treatment conditions analysis of patients with multi-drug resistance tuberculosis in Shantou

目的分析和研究汕头市实施全球基金耐多药结核病项目患者治疗及转归情况,为下一步耐多药肺结核(MDR-TB)患者的治疗与管理提供参考依据。方法通过中国疾病预防控制信息系统结核病专报信息系统,分析2009年4月1日-2014年6月30日汕头市结核病防治所门诊确诊为MDR-TB并纳入全球基金耐多药结核病项目治疗及转归情况。结果共确诊202例耐多药肺结核患者,178例纳入项目进行标准化方案治疗,纳入率88.1%;其中125例完成24个月标准化方案治疗疗程,疗程结束后一年内5次痰结核杆菌培养阴性,治愈率71.2%(89/125)。不同性别、年龄组和不同登记类别的治愈率结果差异无统计学意义(P>0.05)。结论耐多药肺结核疗程长,治愈率低,一方面要积极推广使用耐药快速诊断技术对耐多药肺结核病人的早发现、早诊断,提高确诊耐多药肺结核患者治疗的纳入率,从源头上控制耐多药肺结核的传播;另一方面要加强健康教育,提高患者接受治疗的依从性,有效控制耐多药肺结核疫情。

Objective To analyze the treatment and outcome conditions of the patients who were implemented the global fund project of multi-drug resistance in Shantou City,in order to provide the reference bases for the next step treatment and management of MDR-TB patients.Methods The treatment and outcome conditions of patients with MDR-TB who were diagnosed by the TB dispensary clinic and incorporated into the global fund MDR-TB project from April 1,2009 to June 30,2014 in Shantou were analyzed.Results 202 MDR-TB patients were diagnosed,178 of them were incorporated into the project to do the standard treatment scheme and the rate of incorporation was 88.1%.125 cases of them did the cultivation of sputum mycobacterium tuberculosis more than five times in12 months after they completed the standard treatment scheme for 24 months and the cure rate was 71.2%（ 89/125）.There was no statistically significant difference in cure rate of different sex,age and different types of registration（ P 〉？ 0.05）.Conclusion The longer time MDR-TB treatment is,the lower the cure rate is.On the one hand,we should promote the drug resistance rapid diagnostic techniques for early diagnosis of MDR-TB patients,increasing the incorporation rate of the treatment of the diagnosed MDR-TB patients and controlling the spread of MDRTB from the origin.On the other hand,we should strengthen health education,increasing the compliance for the treatment of patients and controlling the MDR-TB epidemic situation effectively.