论文部分内容阅读
目的了解乌鲁木齐市肺结核患者耐药状况和特点及影响因素,为治疗耐多药结核病(multiple drug resistance tuberculosis,MDR-TB)和防治规划提供可靠的科学依据。方法对2014年乌鲁木齐市结核病定点医疗机构收治的肺结核患者用罗氏管进行分枝杆菌分离培养阳性者共201例,并采用比例法对8种抗结核药物:利福平(RFP)、异烟肼(INH)、乙胺丁醇(EMB)、链霉素(SM)、氧氟沙星(OFX)、卷曲霉素(CPM)、卡那霉素(KM)、阿米卡星(AK)进行药物敏感性试验,分析耐药率及影响因素。结果 201例肺结核患者对8种药总耐药率为19.90%,单耐药率最高为SM(13.43%),最低为AK、Km(均为0.49%);耐多药率为(MDR-TB)6.46%(13/201),广泛耐药率为(extensively drug resistant tuberculosis,XDR-TB)1.49%(3/201)。初复治患者耐药率分别为16.9%和41.7%,耐多药率分别为5.1%和16.7%,两组间差异有统计学意义(P<0.05)。结核病患者的耐药率由高到低依次为对SM、INH、RFP、OFX、EMB、CPM、AK、Km。其耐药性与性别(OR=3.303,95%CI:1.243~8.778)、治疗史(OR=2.586,95%CI:0.355~12.623)有关;且男性高于女性,复治患者高于初治患者。结论乌鲁木齐地区结核分枝杆菌耐药情况严重,特别是耐多药比例偏高,复治患者耐药率和耐多药率均明显高于初治患者,应引起高度重视。
Objective To understand the drug resistance status, characteristics and influencing factors of patients with pulmonary tuberculosis in Urumqi and to provide a reliable scientific basis for the treatment of multiple drug resistance tuberculosis (MDR-TB) and prevention and control programs. Methods A total of 201 cases of pulmonary tuberculosis patients admitted to Urumqi TB Hospital in Urumqi with Romyelomycetes were enrolled in this study. Eight types of anti-tuberculosis drugs, including rifampicin (RFP), isoniazid (INH), ethambutol (EMB), streptomycin (SM), ofloxacin (OFX), capreomycin (CPM), kanamycin (KM), amikacin Drug susceptibility test, analysis of drug resistance and influencing factors. Results The total drug resistance rate of 201 patients with tuberculosis was 19.90%. The highest single drug resistance rate was SM (13.43%), the lowest was AK and Km (0.49%). The multidrug resistance rate was (MDR-TB ) 6.46% (13/201) and extensively drug-resistant tuberculosis (XDR-TB) 1.49% (3/201). The rates of resistance in primary re-treatment patients were 16.9% and 41.7%, respectively, and the multidrug resistance rates were 5.1% and 16.7% respectively. There was significant difference between the two groups (P <0.05). The resistance rates of TB patients from high to low were as follows: SM, INH, RFP, OFX, EMB, CPM, AK, Km. (OR = 3.303, 95% CI: 1.243-8.778), the history of treatment (OR = 2.586, 95% CI: 0.355-12.623); and the male was higher than the female, patient. Conclusion The drug resistance of Mycobacterium tuberculosis is serious in Urumqi area, especially in the areas of MDR and MDR. The rates of drug resistance and multidrug resistance in retreatment patients are significantly higher than those in untreated patients, which should be paid more attention.