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目的 了解新疆维吾尔自治区肺结核患者的耐药状况.方法 选择新疆维吾尔自治区33个县(市、区)2015年1月1日至12月31日期间新登记的涂阳肺结核患者中培养阳性的菌株,共1803株.采用比例法药物敏感性试验(简称“药敏试验”),获得菌株对利福平(RFP)、异烟肼(INH)、乙胺丁醇(EMB)、链霉素(Sn)、卡那霉素(Km)、阿米卡星(Am)、氧氟沙星(Ofx)和卷曲霉素(Cm)的耐药率及耐药谱情况.结果 一线药物(INH、RFP、EMB、Sm)总耐药率为31.39％(566/1803),其中初治患者的耐药率为27.83％(352/1265),复治患者的耐药率为39.78％(214/538);耐多药率为3.99％(72/1803),其中初治患者的耐多药率为2.69％(34/1265),复治患者的耐多药率为7.06％(38/538).二线药物(Km、Am、Ofx、Cm)总耐药率为3.77％(68/1803),其中初治患者耐药率为3.79％(48/1265),复治患者耐药率为3.72％(20/538);完成药敏试验的患者8种抗结核药物的耐药性检测结果显示,耐药率排名前5位者分别为INH(13.03％,235/1803)、Sm(9.37％,169/1803)、RFP(8.60％,155/1803)、Ofx(2.77％,50/1803)和EMB (0.39％,7/1803).男性结核病患者耐药率为40.09％(374/933),女性为29.89％(260/870),差异有统计学意义(x2=20.55,P＜0.001);≤30岁年龄组,30～59岁年龄组和≥60岁年龄组耐药率分别为31.30％(118/377)、43.93％(282/642)和29.85％(234/784),差异有统计学意义(x2=33.81,P＜0.001).复治和初治患者耐药率分别为43.49％(234/538)和31.62％(400/1265),差异有统计学意义(x2=23.34,P＜0.001).结论 新疆总体耐药情况较为严峻,特别要重点关注耐药疫情发展趋势,建立持续的结核病耐药水平动态监测,为耐药结核病防治工作提供理论支持.“,”Objective To understand the prevalence of drug resistant pulmonary tuberculosis (PTB) in Xinjiang region.Methods Thirty-three counties in Xinjiang were randomly sampled and involved in the surveillance.All smear-positive PTB patients who newly registered from 1 January to 31 December 2015 in the selected 33 countries were given sputum culture examinations and obtained 1803 strains of cuhure-positive mycobacteria.The in vitro drug susceptibility testing (DST) of those strains were performed for 8 anti-TB drugs using the proportion method,including rifampin (RFP),isoniazid (INH),ethylamine butanol (EMB),streptomycin (Sm),kanamycin (Km),amikacin (Am),ofloxacin (Ofx),and capreomycin (Cm).The drug resistance rate and the drug resistance patterns were obtained.Results The overall drug resistance rate to four first-line anti-TB drugs (INH,RFP,EMB,Sn) was 31.39％ (566/1803),and it was 27.83％ (352/1265) and 39.78％ (214/538) respectively among new PTB patients and retreatment PTB patients.The multidrug-resistance (MDR) rate was 3.99％ (72/1803) in all PTB patients,and it was 2.69％ (34/1265) and 7.06％ (38/538) respectively among new PTB patients and retreatment PTB patients.The overall drug resistance rate to four second-line anti-TB drugs (Km、Am、Ofx、Cm) was 3.77％ (68/1803),and it was 3.79％ (48/1265) and 3.72％ (20/538) respectively among new PTB patients and retreatment PTB patients.INH mono resistance was the most common form (13.03％,235/1803),followed by Sm (9.37％,169/1803),RFP (8.60％,155/1803),Ofx (2.77％,50/1803) and EMB (0.39％,7/1803).The prevalence of drug resistance among male and female PTB patients was 40.09％ (374/933) and 29.89％ (260/870) respectively,and the difference was statistically significant (x2=20.55,P＜ 0.001).The prevalence of drug resistance was different in PTB patients of different age groups:it was 31.30％ (118/377) among those aged ≤30 years,43.93％ (282/642) among those aged 30-59 years,and 29.85％ (234/784) among those aged ≥60 years;the difference was statistically different (x2=33.81,P＜0.001).The overall prevalence of drug resistance in new PTB patients and retreatment PTB patients was 43.49％ (234/538) and 31.62％ (400/1265)respectively,the difference was statistically different (x2 =23.34,P＜0.001).Conclusion The prevalence of drug resistant tuberculosis is high in Xinjiang,and the trend of drug resistance in PTB patients should be paid much attention.The effective monitoring mechanism and method to the drug resistance of TB should be established,which may provide theoretical support for management of drug resistant tuberculosis.