结核病患者422例耐药情况调查研究

Analysis of drug resistance in 422 hospitalized patients with tuberculosis

目的:了解近期陕西省结核病患者的耐药情况,为防控结核病疫情提供参考依据。方法:同时进行了结核菌一二线药敏检查的422例患者为调查对象,回顾性分析其临床资料及药敏结果。数据采用SPSS 13.0软件进行统计分析。结果:纳入研究的422例患者中总耐药率为38.6%(163/422),耐多药率为10%(42/422),其中初始总耐药率为34.2%(118/345),耐多药率为7.0%(24/345);获得性总耐药率为58.4%(45/77),耐多药率为23.4%(18/77)。10种受试药物耐药率由高到低顺位为异烟肼(23.9%)、链霉素(21.8%)、利福平(16.4%)、乙胺丁醇(14.5%)、左氧氟沙星(5.0%)、莫氟沙星(3.3%)、对氨基水杨酸钠(2.8%)、阿米卡星(1.4%)、卷曲霉素(1.2%)、丙硫异烟胺(0.7%)。结论:目前结核病患者耐药情况依然严峻,应进一步加强结核病患者管理。

Objective:To understand the recent drug resistance of tuberculosis patients in Shaanxi Province,and provide reference for prevention and control of tuberculosis epidemic.Methods:422 patients who underwent a first-and second-line susceptibility test for tuberculosis were selected as subjects.The clinical data and drug susceptibility results were retrospectively analyzed.The data were statistically analyzed by SPSS 13.0 software.Results:The overall drug resistance rate was 38.6%(163/422)in the 422 patients enrolled in the study,and the multidrug resistant rate was 10%(42/422),of which the initial total drug resistance rate was 34.2%(118/345).The multidrug resistance rate was 7.0%(24/345).The total acquired drug resistance rate was 58.4%(45/77),and the multidrug resistance rate was 23.4%(18/77).The resistance rates of the 10 tested drugs from high to low were ashes(23.9%),streptomycin(21.8%),rifampicin(16.4%),ethambutol(14.5%),levofloxacin(5.0%),mofloxacin(3.3%),sodium p-aminosalicylate(2.8%),amikacin(1.4%),capreomycin(1.2%),propionamide(0.7%).Conclusion:The current drug resistance of tuberculosis patients in our province is still severe,and the management of tuberculosis patients should be further strengthened.