试析肺结核患者抗结核药耐药性2657例

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doi:10.3969/j.issn.1007-614x.2014.12.12
摘 要 目的:了解本区结核菌耐药情况。策略:采用回顾性调查,对近8年2 657例肺结核病人耐药性进行分析。结果:总耐药率42.8%,总耐多药率10.3%;耐药率由高到低为INH 24.3%、 17.5%、RFP 14.9%、EMB 13.1%、PZA 11.5%、PAS 8.2%;在不同年龄组中,少年组、青年组、中年组、老年组耐药率分别为10.5%、49.2%、44.8%、35.2%,耐多药率分别为2.8%、12.4%、11.2%、9.5%;耐药率及耐多药率均以40~59岁年龄段最高。结论:高耐药率以及耐药性趋向于一线抗痨药是沈阳市皇姑区胸科医院结核菌耐药特征。
关键词 结核 耐药 抗结核药
Analysis of 2657 cases of anti-tuberculosis drug resistance in tuberculosis patients
Sun Yan1,Zuo Gentong2
The Chest Hospital of Huanggu District,Shenyang City,Liaoning 1100311
The Traditional Chinese Medicine Hospital of Huanggu District,Shenyang City,1100362
Abstract Objective:To investigate TB drug resistance in our district.Methods:We analyzed the drug-resistant of 2657 patients with tuberculosis for the past eight years using a retrospective investigation.Results:The overall resistance rate was 42.8%,the multidrug resistance rate was 10.3%;the resistance rate from high to low were that INH was 24.3%, was 17.5%,RFP was 14.9%,EMB was 13.1%,PZA was 11.5%,PAS was 8.2%.In different age groups,the resistance rates of boys group,youth group,middle-aged group,elderly group were respectively 10.5%,49.2%,44.8%,35.2%,the multidrug resistance rates were respectively 2.8%,12.4%,11.2%,9.5%.The highest of resistance rates and multi肺结核患者抗结核药耐药性2657例相关范文由写论文的好帮手www.808so.com提供,转载请保留.drug resistance rates both were 40 to 59 age.Conclusion:High resistance rates and resistance which tend to first-line anti-tuberculosis drugs are the TB drug resistance characteristics of the chest hospital of Huanggu District in Shenyang City.
Key words Tuberculosis;Drug resistance;Anti-TB drugs
目前,如何治疗耐药性结核病已经成为各方广泛关注的理由。本研究通过对2003年6月-2011年6月沈阳市皇姑区胸科医院门诊及住院结核病患者耐药情况进行回顾性分析,了解结核分枝杆菌耐药的情况,为制订合理的治疗方案提供依据,现报告如下。
资料与策略
2003年6月-2011年6月对痰培养阳性的标本做出菌型鉴定及6种抗结核药的药物敏感试验,共2 657人,初治患者1 998例,复治患者659例。按年龄分组:①少年组:60岁,505例。
策略:①菌种鉴定:使用对硝基苯甲酸(PNP)、噻吩-2-羧酸肼(TCH)等鉴别培养基对临床分离株进行分支杆菌鉴定。②药敏试验:采用无淀粉改良罗氏培养基进行药物敏感性测定,采用绝对浓度间接法,配制培养基及药敏试验的过程严格按照中国防痨协会制定的结核病诊断细菌学检验规程的要求执行[1]。③试验药物:异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)、吡嗪酰胺(PZA)、链霉素()、对氨基水杨酸钠(PAS)。
相关定义:①原发性耐药:先前从未服用过任何抗结核药物,所感染耐药结核菌的现象;②初始耐药:用药情况不详或用药时间不超过1个月而出现的结核菌耐药现象;③获得性耐药:接触抗结核药物的过程中发生耐药性,持续用药1个月及以上发生耐药性的现象;④耐药结核病:对于1种或1种以上的抗结核药物耐药,通常为肺结核患者;⑤耐多药结核病(MDR-TB):指结核菌对2种及以上的强力抗结核药物,至少对异烟肼和利福平,具有耐药性,这是耐药结核的一种特定形式。
结 果
总体耐药情况:2003年6月-2011年6月收治结核分枝杆菌感染患者2 657例,其中符合初治条件1 998例,符合复治条件659例,对1种或1种以上药物耐药1137例,总体耐药率42.8%。对INH、RFP同时耐药,即MDR-TB 374例,耐药率10.3%。不同结核药耐药率从高到低为INH 24.3%、 17.5%、RFP 14.9%、EMB 13.1%、PZA 11.5%、PAS 8.2%。肺结核患者抗结核药耐药性2657例论文资料由论文网www.808so.com提供,转载请保留地址.

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