四川省平原与丘陵地区菌阳肺结核比较分析

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目的了解四川省平原与丘陵地区菌阳肺结核的发病差异、菌型及耐药性概况,为不同地区采用不同结核病控制策略提供科学依据。方法选择四川省结核病耐药监测点中平原地区的双流县和丘陵地区的隆昌县,收集2009年菌阳肺结核病例,对分离培养阳性的菌株进行耐药性测定和菌种初步鉴定。结果双流县2009年发现菌阳肺结核患者246例(培养阳性172例),菌阳发病率27/10万,检出1例非结核分枝杆菌,总耐药率34.88%(60/172),其中耐单药49例,耐2药9例,耐多药2例;隆昌县2009年发现菌阳肺结核患者374例(培养阳性99例),菌阳发病率为53/10万,检出11例非结核分枝杆菌,总耐药率为32.32%(32/99),其中耐单药18例、耐2药2例、耐多药12例。隆昌县肺结核菌阳发病率高于双流县,差异有统计学意义(χ2=8.45,P<0.01);2县总耐药率比较无统计学意义(χ2=0.12,P>0.05),隆昌县耐多药肺结核患者明显多于双流县,差异有统计学意义(χ2=16.7,P<0.01)。结论四川省丘陵地区结核病菌阳患病率及结核菌耐多药率相对高于平原地区,应采取相应措施。 Objective To understand the difference of pathogens, bacterial strains and drug resistance in the plains and hilly areas of Sichuan Province and provide scientific evidence for different tuberculosis control strategies in different areas. Methods In Shuangliu County and Longchang County in the hilly area in the middle part of Sichuan Province where TB drug resistance was detected in Sichuan Province, 2009 cases of bacillary positive pulmonary tuberculosis were collected, and the drug resistance and initial identification of strains isolated and cultured were collected. Results In Shuangliu County, 246 cases of positive pulmonary tuberculosis (positive 172 cases) were found in 2009 and the incidence rate of bacteria was 271,000. One case of non-tuberculous mycobacterium was detected with a total resistance rate of 34.88% (60/172) Among them, 49 cases were resistant to monotherapy, 9 cases were resistant to 2 drugs and 2 cases were multidrug-resistant. In 2009, 374 cases of bacillary positive pulmonary tuberculosis were found in Longchang County (positive culture was 99 cases) Cases of non-TB Mycobacterium tuberculosis, the total resistance rate was 32.32% (32/99), of which 18 were resistant to monotherapy, resistance to 2 drugs in 2 cases, MDR in 12 cases. The prevalence of pulmonary tuberculosis in Longchang County was higher than that in Shuangliu County (χ2 = 8.45, P <0.01). There was no significant difference in the total drug resistance between the two counties (χ2 = 0.12, P> 0.05) MDR-TB patients were significantly more than Shuangliu County, the difference was statistically significant (χ2 = 16.7, P <0.01). Conclusion The prevalence of tuberculosis bacilli in mountainous areas of Sichuan Province and the multidrug-resistant rate of tuberculosis are relatively higher than those in plain areas, and corresponding measures should be taken.
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